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Khomyakova E.N.

Moscow Regional Research and Clinical Institute, 61/2-11 Shchepkina St., Moscow, Russian Federation, 129110

Ryabtseva A.A.

Vladimirsky Moscow Regional Research Clinical Institute, Moscow

Sergushev S.G.

State Research Center Burnasyan Federal Medical Biophysical Center of the Federal Medical-Biological Agency, 15 Gamalei St., Moscow, Russian Federation, 123098

Grishina Е.Е.

Bashkir State Medical University, Ufa

Combination therapy in patients with concomitant macular edema and proliferative diabetic retinopathy

Authors:

Khomyakova E.N., Ryabtseva A.A., Sergushev S.G., Grishina Е.Е.

More about the authors

Journal: Russian Annals of Ophthalmology. 2019;135(6): 67‑72

DOI: 10.17116/oftalma201913506167

Views: 1411

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To cite this article:

Khomyakova EN, Ryabtseva AA, Sergushev SG, Grishina ЕЕ. Combination therapy in patients with concomitant macular edema and proliferative diabetic retinopathy. Russian Annals of Ophthalmology. 2019;135(6):67‑72. (In Russ.)
https://doi.org/10.17116/oftalma201913506167

Подписка 2025 (Russian Annals of Ophthalmology)
 
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Diabetic macular edema (DME) is a serious complication of diabetic retinopathy. Numerous multicenter studies of the effectiveness of various treatment methods for DME do not give unambiguous recommendations for the treatment of refractory DME, and combinations of various forms of therapy continue to be actively studied. Purpose — to study the effectiveness of the combination of intravitreal administration of the drug Ozurdex with subsequent individually selected laser therapy in the treatment of the proliferative stage of diabetic retinopathy in patients with concomitant chronic DME, and its relationship with morphological changes in the retina observed with optical coherence tomography. Material and methods. This retrospective study included 18 patients with insulin-requiring type II diabetes mellitus complicated by diabetic retinopathy in the proliferative stage and refractory DME. According to morphological changes observed with optical coherence tomography of the retina, the patients were divided into 3 groups: 6 patients with diffuse macular edema, 6 patients with cystic macular edema, and 6 patients with serous detachment of the retinal neuroepithelium. All patients underwent intravitreal injection of 0.7 mg Ozurdex followed by panretinal laser coagulation. The choice of laser applicates with the minimal parameters giving a therapeutic effect was carried out according to the procedure described previously (Patent No. RU2611887C1 d.d. 12/25/2015). Results. The combination of intravitreal administration of Ozurdex followed by individually selected laser coagulation is effective against various morphological types of DME. However, the greatest visual acuity was achieved in patients with diffuse macular edema and retinal neuroepithelial detachment. Conclusion. The higher the initial visual acuity, the better the functional outcomes of the treatment. Baseline retinal thickness did not affect the effectiveness of the proposed method of treatment. Cystic macular edema was an unfavorable prognostic factor for improving visual acuity.

Keywords:

type II diabetes mellitus
insulin-requiring diabetes
macular edema
proliferative diabetic retinopathy
optical coherence tomography
DEX DDS
retinal laser coagulation

Authors:

Khomyakova E.N.

Moscow Regional Research and Clinical Institute, 61/2-11 Shchepkina St., Moscow, Russian Federation, 129110

Ryabtseva A.A.

Vladimirsky Moscow Regional Research Clinical Institute, Moscow

Sergushev S.G.

State Research Center Burnasyan Federal Medical Biophysical Center of the Federal Medical-Biological Agency, 15 Gamalei St., Moscow, Russian Federation, 123098

Grishina Е.Е.

Bashkir State Medical University, Ufa

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