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Year : 2017  |  Volume : 18  |  Issue : 3  |  Page : 160-165

Retinal ellipsoid zone/external limiting membrane restoration after diabetic macular edema treatment

Ophthalmology Departement, Kasr Al Ainy Medical School, Cairo University, Cairo, Egypt

Correspondence Address:
Nehal M. Samy El Gendy
43 Gameat el Dewal AlArabia street, Al Mohandeseen District, Giza
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/DJO.DJO_13_17

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Purpose The aim of this study was to determine which clinically significant diabetic macular edema treatment modality results in early restoration of the ellipsoid zone and external limiting membrane (EZ/ELM). Patients and methods This was a retrospective study where the medical records of patients with type 2 diabetes mellitus and clinically significant diabetic macular edema were reviewed. Patients who had valid scans before treatment and 6 months after treatment were included. Disruption of EZ/ELM was graded and compared. Patients were divided into six groups according to the treatment received: group A received argon laser treatment; group B received micropulse diode laser treatment; group C received antivascular endothelial growth factor (anti-VEGF) treatment; group D received anti-VEGF+laser therapy; group E received triamcinolone acetonide injection (TAI); and group F received TAI+laser therapy. Results A total of 293 eyes of 200 patients were included (group A: 47, group B: 40, group C: 52, group D: 54, group E: 51, and group F: 49 eyes). Improvement in EZ/ELM integrity was 38.3% in group A, 45% in group B, 59.6% in group C, 37% in group D, 54.9% in group E, and 44.9% in group F. The difference between groups A and B was not statistically significant (P=0.3). The differences between group A and groups C, D, and E were statistically significant (P=0.002, 0.006, and 0.02, respectively). The difference between groups A and F was not significant (P=0.2). The difference between groups C and D was significant (P=0.001), whereas the difference between groups E and F was not significant (P=0.15). Conclusion Anti-VEGF monotherapy showed the highest percentage of early EZ/ELM restoration. Argon laser alone or argon laser combined with anti-VEGF delayed EZ/ELM healing. Micropulse laser therapy was equivalent to argon laser therapy. TAI results were comparable with anti-VEGF results. Laser addition did not compromise TAI results.

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