Efficacy of micropuls laser in the treatment of diabetic maculer edema

Aim: In this study, we aimed to evaluate and compare the visual acuity, macular volume, central macular thickness, injection needs of ranibizumab injection and micropulse laser applications before and after treatment of DME patients. Materials and Methods: This study was carried out on 97 patients (45 ranibizumab and 52 micropuls laser) with diabetic macular edema who were diagnosed in the Retina Polyclinic of Manisa Celal Bayar University Ophthalmology Department between May 1, 2018 and January 1, 2019. At the control visit of 3 injections administered once a month, micropuls laser was applied to one group and ranibizumab injection was continued to the other group for an average of 9.27 ± 2.42 months and central macular thickness, macular volume and visual acuity were recorded. The data were analyzed with the appropriate statistical methods in SPSS 21.0 program. Results: The mean follow-up period was 9.27 ± 2.42 months in this study in which 97 patients who were treated with ranibizumab injection with micropuls laser (n = 52) and only ranibizumab injection (n = 45) were evaluated. There was no significant difference between the groups in terms of gender, smoking and systemic diseases, initial central macular thickness, macular volume and visual acuity measurements (p> 0.05). Positive changes were observed in central macular thickness, macular volume and visual acuity values of both micropulse and injection groups within the control group (3rd month) and monthly control after loading therapy (until 14th month). These changes were not statistically significant (p> 0.05). Central macular thickness, macular volume and visual acuity values measured at the last follow-up of the patients were not significantly different between the groups (p> 0.05). The mean post-treatment injection requirement was 4.19 ± 1.01 for the ranibizumab with micropuls laser group and 5.53 ± 1.14 for the ranibizumab group. In the group treated with micropuls laser, statistically less intravitreal ranibizumab injections were needed (p <0.001). Conclusion: Both methods were effective in the treatment of DME and micropulse treatment was superior to the need for injection. In line with the results of this study, future studies with the participation of more people will be effective in the selection of treatment by comparing micropulse laser with different methods. Keywords: Diabetic Macular Edema, Micropuls Laser, Ranibizumab injection, Central Macular Thickness, Macular Volume