Research Article
Volume 11 Issue 4 - 2020
Comparison of Anti VEGF and Laser Photocoagulation in Diabetic Macular Edema (DME)
Salma Mahmoud El Awad1, Nuha Mohamed Fath Elrahman2, Muhammad Ijaz Ahmad3, Abd Elaziz Mohamed Elmadina4*, Manzoor Ahmad Qureshi5, Adil Mousa Younis6, Abrar Ahmad Bhatti7 and Mosab Nouraldein Mohammed Hamad8
1Postgraduate Student in Alneelain University, Khartoum, Sudan
2Assistant Professor, Faculty of Optometry and Visual Science, Alneelain University, Khartoum, Sudan
3Assistant Professor Ophthalmology, Qassim Medical University, Saudi Arabia and Allied Hospital, Department of Ophthalmology, Punjab Medical College, Faisalabad, Pakistan
4Assistant Professor, Faculty of Optometry and Visual Science, Alneelain University, Sudan and Assistant Professor, Optometry Department, College of Applied Medical Sciences, Qassim University, Saudi Arabia
5Assistant Professor of Ophthalmology, Qassim Medical University, Saudi Arabia and Department of Ophthalmology, Liaquat University of Medical and Health Sciences, Jamshoro, Hyderabad, Pakistan
6Associate Professor Q.U.S.A. CEB, Saudi Arabia
7Consultant Ophthalmologist King Fahd Specialist Hospital Buraidha, KSA and Services Institute of Medical Sciences Lahore (SIMS), Services Hospital, Pakistan
8Faculty of Health Sciences, Elsheikh Abdallah Elbadri University, Sudan
*Corresponding Author: Abd Elaziz Mohamed Elmadina, Assistant Professor, Faculty of Optometry and Visual Science, Alneelain University, Sudan and Assistant Professor, Optometry Department, College of Applied Medical Sciences, Qassim University, Saudi Arabia.
Received: February 19, 2020; Published: March 12, 2020


Background: To investigate the relationship of central macular thickness measure and visual acuity in diabetic macular edema (DME) before and after treatments using Ranibizumab, Bevacizumab and laser.

Materials and Methods: A comparative cross-sectional retrospective study was done in Khartoum state at Al Faisal Eye Center. Heidelberg OCT was used to measure central macular thickness and visual acuity (BCVA) was evaluated by Snellen’s chart. The data were analyzed by SPSS 20.

Result: A total of 102 treated patients including both male/female were enrolled with mean age 55 ± 5.41. Paired sample t-test showed a significant difference in all types of treatments based on mean vision of treated patients. With Ranibizumab the pre and post treatment mean vision was (0.20 ± 0.16) and (0.30 ± 0.25) respectively with t (-3.2) and P value 0.002. With Bevacizumab it was (0.18 ± 0.16) and (0.37 ± 0.26) respectively with t (-6.12) P value < 0.001 and with laser it was (0.28 ± 0.20) and (0.38 ± 0.27) respectively with t (-2.8) and P value 0.008.A significant difference was found in all types of treatments regarding mean of central macular thickness of treated patients. In patients treated with Ranibizumab the pre and post treatment thickness was (403.6 ± 127) and (293.6 ± 72.7) respectively with t (5.92), with Bevacizumab it was (389.3 ± 134.2) and (276.1 ± 62.6) respectively with t (5.93) and with laser it was (370.1 ± 120.7) and (280.9 ± 64.3) respectively with t (4.67) and P value < 0.001.

Conclusion: Diabetic macular edema leads to blurred vision ranging from slight blurring to noticeable vision loss and Bevacizumab showed sustained improvements in vision and retinal anatomy than Ranibizumab and laser.

 Keyword: Central Macular Thickness; Vascular Endothelial Growth Factor; Vision; Diabetic Macular Edema; Ocular Coherence Tomography


  1. Kanski Jack J. “Clinical ophthalmology: a systematic approach”. 7th edition-black pool, UK (2011): 633.
  2. The national eye institute (NEI) department of health and human. USA (2015).
  3. Early treatment diabetic retinopathy study research group. “Photocoagulation for diabetic macular edema early treatment diabetic retinopathy study report number 1”. Archives of Ophthalmology 103.12 (1985): 1796-1806.
  4. "Early treatment diabetic retinopathy study research group. Early photocoagulation for diabetic retinopathy ETDRS report number 9”. Ophthalmology 98.5 (1991): 766-785.
  5. The diabetes control and complication trial research group. “The effect of intensive treatment of intensive treatment of diabetes on the development and progression of long -term complications in insulin-dependent diabetes mellitus”. New England Journal of Medicine 329 (1993): 977-986. 
  6. Matthews DR., et al. “Risks of progression of retinopathy and vision loss related to tight blood pressure control in type2 diabetes mellitus UKPDS69”. Archives of Ophthalmology 122.11 (2004): 1631-1640.
  7. Kanski Jack J. “Clinical ophthalmology: a systematic approach”. 7th edition-black pool, UK (2011): 624.
  8. Hee MR., et al. “Quantitative assessment of macular edema with optical coherence tomography”. Archives of Ophthalmology 113.8 (1995): 1019-1029.
  9. Hee MR., et al. “Optical coherence tomography of human retina”. Archives of Ophthalmology 113.3 (1995): 325-332.
  10. Toth CA., et al. “A comparison of retinal morphology viewed by optical coherence tomography and by light microscopy”. Archives of Ophthalmology 115.11 (1997): 1425-1428.
  11. Heier JS., et al. “Ranibizumab for treatment of neovascular age related macular degeneration”. Ophthalmology 113.4 (2006): 633.e1-e4.
  12. Jorge EC., et al. “Monotherapy laser Photocoagulation for diabetic macular oedema”. Cochrane Database of Systematic Reviews 10 (2018): CD010859. 
  13. Pere Romero-Aroca. “Is laser photocoagulation treatment currently useful in diabetic macular edema?” Medical Hypothesis, Discovery and Innovation in Ophthalmology 4.1 (2015): 5-8.
  14. Romero-Aroca P., et al. “Laser treatment for diabetic macular edema in the 21st century”. Current Diabetes Reviews 10.2 (2014): 100-102.
  15. Distefano LN., et al. “Combination of Anti-VEGF and Laser Photocoagulation for Diabetic Macular Edema: A Review”. Journal of Ophthalmology (2017): 2407037.
  16. Shao Y., et al. “Clinical observation of the efficacy of Bevacizumab  combined with argon green laser in treating fundus macular edema”. Experimental and Therapeutic Medicine 13.4 (2017): 1480-1484.
  17. Diabetic retinopathy clinical research network., et al. “Ranibizumb plus prompt or deferred laser or triamcinolone plus prompt laser for diabetic macular edema”. Ophthalmology 117.6 (2010): 1064-1077.
  18. Avrey RL. “Regression of retinal and iris neovascularization after intravitral bevacizumzb (avastin) treatment”. Retina 26.3 (2006): 352-354.
  19. Retinal Photocoagulation (2011).
  20. “Focal photocoagulation treatment of diabetic macular edema. Early treatment Diabetic retinopathy study research group. Archives of Ophthalmology 113.9 (1995): 1144-1155.
  21. Shimura M., et al. “Pan retinal photocoagulation induces pro-inflammatory cytokines and macular thickening in high-risk proliferative diabetic retinopathy”. Graefe's Archive for Clinical and Experimental Ophthalmology 247.12 (2009): 1617-1624.
  22. Son BK., et al. “Comparison of Ranibizumab and Bevacizumab for Macular Edema Associated with Branch Retinal Vein Occlusion”. Korean Journal of Ophthalmology 31.3 (2017): 209-216.
Citation: Abd Elaziz Mohamed Elmadina., et al. “Comparison of Anti VEGF and Laser Photocoagulation in Diabetic Macular Edema (DME)”. EC Ophthalmology 11.4 (2020): 19-24.

PubMed Indexed Article

EC Pharmacology and Toxicology
LC-UV-MS and MS/MS Characterize Glutathione Reactivity with Different Isomers (2,2' and 2,4' vs. 4,4') of Methylene Diphenyl-Diisocyanate.

PMID: 31143884 [PubMed]

PMCID: PMC6536005

EC Pharmacology and Toxicology
Alzheimer's Pathogenesis, Metal-Mediated Redox Stress, and Potential Nanotheranostics.

PMID: 31565701 [PubMed]

PMCID: PMC6764777

EC Neurology
Differences in Rate of Cognitive Decline and Caregiver Burden between Alzheimer's Disease and Vascular Dementia: a Retrospective Study.

PMID: 27747317 [PubMed]

PMCID: PMC5065347

EC Pharmacology and Toxicology
Will Blockchain Technology Transform Healthcare and Biomedical Sciences?

PMID: 31460519 [PubMed]

PMCID: PMC6711478

EC Pharmacology and Toxicology
Is it a Prime Time for AI-powered Virtual Drug Screening?

PMID: 30215059 [PubMed]

PMCID: PMC6133253

EC Psychology and Psychiatry
Analysis of Evidence for the Combination of Pro-dopamine Regulator (KB220PAM) and Naltrexone to Prevent Opioid Use Disorder Relapse.

PMID: 30417173 [PubMed]

PMCID: PMC6226033

EC Anaesthesia
Arrest Under Anesthesia - What was the Culprit? A Case Report.

PMID: 30264037 [PubMed]

PMCID: PMC6155992

EC Orthopaedics
Distraction Implantation. A New Technique in Total Joint Arthroplasty and Direct Skeletal Attachment.

PMID: 30198026 [PubMed]

PMCID: PMC6124505

EC Pulmonology and Respiratory Medicine
Prevalence and factors associated with self-reported chronic obstructive pulmonary disease among adults aged 40-79: the National Health and Nutrition Examination Survey (NHANES) 2007-2012.

PMID: 30294723 [PubMed]

PMCID: PMC6169793

EC Dental Science
Important Dental Fiber-Reinforced Composite Molding Compound Breakthroughs

PMID: 29285526 [PubMed]

PMCID: PMC5743211

EC Microbiology
Prevalence of Intestinal Parasites Among HIV Infected and HIV Uninfected Patients Treated at the 1o De Maio Health Centre in Maputo, Mozambique

PMID: 29911204 [PubMed]

PMCID: PMC5999047

EC Microbiology
Macrophages and the Viral Dissemination Super Highway

PMID: 26949751 [PubMed]

PMCID: PMC4774560

EC Microbiology
The Microbiome, Antibiotics, and Health of the Pediatric Population.

PMID: 27390782 [PubMed]

PMCID: PMC4933318

EC Microbiology
Reactive Oxygen Species in HIV Infection

PMID: 28580453 [PubMed]

PMCID: PMC5450819

EC Microbiology
A Review of the CD4 T Cell Contribution to Lung Infection, Inflammation and Repair with a Focus on Wheeze and Asthma in the Pediatric Population

PMID: 26280024 [PubMed]

PMCID: PMC4533840

EC Neurology
Identifying Key Symptoms Differentiating Myalgic Encephalomyelitis and Chronic Fatigue Syndrome from Multiple Sclerosis

PMID: 28066845 [PubMed]

PMCID: PMC5214344

EC Pharmacology and Toxicology
Paradigm Shift is the Normal State of Pharmacology

PMID: 28936490 [PubMed]

PMCID: PMC5604476

EC Neurology
Examining those Meeting IOM Criteria Versus IOM Plus Fibromyalgia

PMID: 28713879 [PubMed]

PMCID: PMC5510658

EC Neurology
Unilateral Frontosphenoid Craniosynostosis: Case Report and a Review of the Literature

PMID: 28133641 [PubMed]

PMCID: PMC5267489

EC Ophthalmology
OCT-Angiography for Non-Invasive Monitoring of Neuronal and Vascular Structure in Mouse Retina: Implication for Characterization of Retinal Neurovascular Coupling

PMID: 29333536 [PubMed]

PMCID: PMC5766278

EC Neurology
Longer Duration of Downslope Treadmill Walking Induces Depression of H-Reflexes Measured during Standing and Walking.

PMID: 31032493 [PubMed]

PMCID: PMC6483108

EC Microbiology
Onchocerciasis in Mozambique: An Unknown Condition for Health Professionals.

PMID: 30957099 [PubMed]

PMCID: PMC6448571

EC Nutrition
Food Insecurity among Households with and without Podoconiosis in East and West Gojjam, Ethiopia.

PMID: 30101228 [PubMed]

PMCID: PMC6086333

EC Ophthalmology
REVIEW. +2 to +3 D. Reading Glasses to Prevent Myopia.

PMID: 31080964 [PubMed]

PMCID: PMC6508883

EC Gynaecology
Biomechanical Mapping of the Female Pelvic Floor: Uterine Prolapse Versus Normal Conditions.

PMID: 31093608 [PubMed]

PMCID: PMC6513001

EC Dental Science
Fiber-Reinforced Composites: A Breakthrough in Practical Clinical Applications with Advanced Wear Resistance for Dental Materials.

PMID: 31552397 [PubMed]

PMCID: PMC6758937

EC Microbiology
Neurocysticercosis in Child Bearing Women: An Overlooked Condition in Mozambique and a Potentially Missed Diagnosis in Women Presenting with Eclampsia.

PMID: 31681909 [PubMed]

PMCID: PMC6824723

EC Microbiology
Molecular Detection of Leptospira spp. in Rodents Trapped in the Mozambique Island City, Nampula Province, Mozambique.

PMID: 31681910 [PubMed]

PMCID: PMC6824726

EC Neurology
Endoplasmic Reticulum-Mitochondrial Cross-Talk in Neurodegenerative and Eye Diseases.

PMID: 31528859 [PubMed]

PMCID: PMC6746603

EC Psychology and Psychiatry
Can Chronic Consumption of Caffeine by Increasing D2/D3 Receptors Offer Benefit to Carriers of the DRD2 A1 Allele in Cocaine Abuse?

PMID: 31276119 [PubMed]

PMCID: PMC6604646

EC Anaesthesia
Real Time Locating Systems and sustainability of Perioperative Efficiency of Anesthesiologists.

PMID: 31406965 [PubMed]

PMCID: PMC6690616

EC Pharmacology and Toxicology
A Pilot STEM Curriculum Designed to Teach High School Students Concepts in Biochemical Engineering and Pharmacology.

PMID: 31517314 [PubMed]

PMCID: PMC6741290

EC Pharmacology and Toxicology
Toxic Mechanisms Underlying Motor Activity Changes Induced by a Mixture of Lead, Arsenic and Manganese.

PMID: 31633124 [PubMed]

PMCID: PMC6800226

EC Neurology
Research Volunteers' Attitudes Toward Chronic Fatigue Syndrome and Myalgic Encephalomyelitis.

PMID: 29662969 [PubMed]

PMCID: PMC5898812

EC Pharmacology and Toxicology
Hyperbaric Oxygen Therapy for Alzheimer's Disease.

PMID: 30215058 [PubMed]

PMCID: PMC6133268

News and Events

April Issue Release

We always feel pleasure to share our updates with you all. Here, notifying you that we have successfully released the April issue of respective journals and the latest articles can be viewed on the current issue pages.

Submission Deadline for upcoming Issue

Ecronicon delightfully welcomes all the authors around the globe for effective collaboration with an article submission for the upcoming issue of respective journals. Submissions are accepted on/before April 26, 2021.

Certificate of Publication

Ecronicon honors with a "Publication Certificate" to the corresponding author by including the names of co-authors as a token of appreciation for publishing the work with our respective journals.

Best Article of the Issue

Editors of respective journals will always be very much interested in electing one Best Article after each issue release. The authors of the selected article will be honored with a "Best Article of the Issue" certificate.

Certifying for Review

Ecronicon certifies the Editors for their first review done towards the assigned article of the respective journals.

Latest Articles

The latest articles will be updated immediately on the articles in press page of the respective journals.

Immediate Assistance

The prime motto of this team is to clarify all the queries without any delay or hesitation to avoid the inconvenience. For immediate assistance on your queries please don't hesitate to drop an email to