الفهرس 
INTRODUCTIONOnly 14 pages are availabe for public view
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Abstract
BACK GROUND:
Diabetic macular edema is a leading cause of visual loss, which is experiencing recent advances in its diagnosis and management.
OBJECTIVES:
The aim of this work was to evaluate different treatment modalities for diabetic macular edema using both fluorescein angiography and optical coherence tomography.
METHODS:
The study was conducted on ninety eyes of 71 patients with diabetic macular edema with no previous macular treatment. Cases were divided into 6 treatment groups of 15 eyes each. All eyes included in the study were subjected to full ophthalmologic examination, best spectacle-corrected visual acuity, anterior segment and fundus examination and preoperative fluorescein angiography and optical coherence tomography. Eyes with significant media opacity or PDR were excluded from this study. The groups were treated respectively by conventional laser photo-coagulation, subthreshold micropulse diode laser, intravitreal triamcinolone injection, vitrectomy, intravitreal triamcinolone –assisted vitrectomy and vitrectomy with internal limiting membrane peeling. Fluorescein angiography and optical coherence tomography were done preoperatively and after 3 and 6 months.
RESULTS:
Conventional laser resulted in significant temporary improvement in macular thickness and minimal change in vision and macular volume. Subthreshold micropulse diode laser resulted in minimal change in vision and macular thickness and volume. Intravitreal triamcinolone injection resulted in significant maintained improvement in vision and significant temporary improvement in macular thickness and volume. Vitrectomy resulted in minimal change in vision and macular thickness and volume. Intravitreal triamcinolone–assisted vitrectomy resulted in minimal change in vision and in maintained significant improvement in macular thickness and volume. Vitrectomy with internal limiting membrane peeling resulted in minimal change in vision and macular thickness and in maintained significant improvement in macular volume.
CONCLUSIONS:
In the primary management of diabetic macular edema, significant maintained visual improvement occurs only with intravitreal triamcinolone injection while significant maintained improvement in macular thickness occurs only with intravitreal triamcinolone–assisted vitrectomy and significant maintained improvement in macular volume occurs only with intravitreal triamcinolone–assisted vitrectomy and vitrectomy with internal limiting membrane peeling.