Optical Coherence Tomography Angiography After Ranibizumab and After Macular Laser Treatment for Diabetic Macular Edema

Ali, Sara Salah Eldin Mahmoud; El-Agouz, Mohammed Hussein; Mahmood, Khulood Muhammed; Abdellah, Marwa Mahmoud

doi:10.21608/svuijm.2023.209031.1581

Optical Coherence Tomography Angiography After Ranibizumab and After Macular Laser Treatment for Diabetic Macular Edema

Document Type : Original research articles

Authors

Ophthalmology Department, Faculty of Medicine, Sohag University, Sohag, Egypt

10.21608/svuijm.2023.209031.1581

Abstract

Background: Diabetic macular edema (DME) is a main cause of visual affection in diabetics. Optical coherence tomography (OCT) and optical coherence tomography angiography (OCTA) are non-invasive technology to have a cross-sectional image of the retina.
Objectives: is to assess macular thickness and ischemia that may occur after injection and after laser clinically and by using OCT and OCTA and its affection on best corrected visual acuity (BCVA).
Patients and methods: prospective, observational, cohort study with a total 89 eyes were enrolled in the study. They were evaluated using OCT and OCTA before and after intravitreal injection of ranibizumab or after macular grid laser used in patients diagnosed with clinically significant diabetic macular edema. They were divided into 2 groups: ranibizumab group (49 eyes) and macular grid laser group (40 eyes).
Results: There was highly significant improvement in BCVA in both groups (p <0.0001). As regard macular thickness there was significant reduction of macular thickness in both groups (p<0.0001). As regard foveal avascular zone (FAZ) there was more enlargement of FAZ post. Laser than post. Injection but this enlargement was non-statistically significant. Vascular density in superficial capillary plexus decreased more post. Laser than post. Injection but this reduction was non-statistically significant. Vascular density in deep capillary plexus decreased more post. Laser than post. Injection but this reduction was non-statistically significant.
Conclusion: Our result concluded that intravitreal injection of ranibizumab and macular grid laser are influential treatment for diabetic macular edema with more ischemia and more effect on macular perfusion with macular laser than with ranibizumab. OCT and OCTA are helpful during follow-up cases with DME to assess macular thickness, degree of macular ischemia and any complication that may result from injection or from laser.

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