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Abstract
Purpose
The aim was to compare efficacy of treatments for diabetic macular oedema (DMO) from changes in visual acuity (VA) and central macular thickness (CMT).
Methods
Peer‐reviewed articles from 2004 to 2014 reporting intravitreal injections of bevacizumab (IVB), ranibizumab (IVR) or triamcinolone acetonide (IVTA) or laser photocoagulation therapy (LPT) provided data on pre‐treatment (baseline) and final outcome measures. Net changes and relative changes (percentage) were assessed by linear regression analyses.
Results
From 88 data sets the overall net change of VA was ‐0.10 ± 0.12 logMAR (mean ± standard deviation), being ‐0.13 ± 0.11 logMAR for IVB, 0 ± 0.08 logMAR for IVR and ‐0.12 ± 0.08 logMAR for IVTA as compared to 0.01 ± 0.14 logMAR for LPT. For CMT, the overall net change was ‐103 ± 71 microns, being ‐108 ± 64 microns for IVB, ‐182 ± 73 microns for IVR, and ‐102 ± 57 microns for IVTA and was ‐49 ± 60 microns for LPT. Overall, modest correlations were found between the absolute central retinal (macular) thickness change and the VA change, and the relative changes in these measures (p < 0.001, r = 0.522 or 0.457). The predicted visual outcome from a 100 microns reduction in CMT was ‐0.083 logMAR units, an effect not substantially influenced by the CMT measurement method.
Conclusions
Pharmacological treatment of DMO can be expected to result in a predictable decrease in CMT with an accompanying increase in VA, with the overall outcome being better than laser treatment.