Preliminary assessment of celecoxib and microdiode pulse laser treatment of diabetic macular edema.
Preliminary assessment of celecoxib and microdiode pulse laser treatment of diabetic macular edema.
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DOI：
10.1097/iae.0b013e3181bcf1a0
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发表时间：
2010-03
期刊：
影响因子：
--
通讯作者：
Ferris FL 3rd
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文献类型：
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作者：
Chew EY;Kim J;Coleman HR;Aiello LP;Fish G;Ip M;Haller JA;Figueroa M;Martin D;Callanan D;Avery R;Hammel K;Thompson DJ;Ferris FL 3rd
炎症可能在糖尿病性黄斑水肿的发病机制中起重要作用，糖尿病性黄斑水肿是糖尿病患者视力丧失的主要原因。本研究的目的是评价联合激光和血管成形术治疗糖尿病性黄斑水肿的疗效。在这项前瞻性、析因、随机、多中心试验中，我们在86名糖尿病黄斑水肿受试者中比较了环氧合酶-2抑制剂（塞来昔布）与安慰剂以及二极管格栅激光与标准早期治疗糖尿病视网膜病变研究焦点激光治疗。主要结局是视力较基线变化≥15个字母，次要结局包括通过光学相干断层扫描测量的糖尿病黄斑水肿视网膜增厚减少50%，荧光素血管造影显示渗漏严重程度减少50%。超过2年随访的视力和视网膜增厚数据没有显示药物治疗和激光治疗之间存在差异的证据。然而，与安慰剂组相比，塞来昔布组的参与者更有可能减少荧光素渗漏（比值比= 3.6; P < 0.01）。这项短期研究未发现塞来昔布或半导体激光治疗与标准激光治疗相比有较大的视功能获益。观察到塞来昔布在减少荧光素渗漏方面的提示作用。
Inflammation may play an important role in the pathogenesis of diabetic macular edema, a major cause of vision loss in persons with diabetes. The purpose of this study was to evaluate combined antiinflammatory therapy and laser approaches for treating patients with diabetic macular edema. In this prospective, factorial, randomized, multicenter trial, we compared cyclo-oxygenase-2 inhibitor (celecoxib) with placebo and diode grid laser with standard Early Treatment Diabetic Retinopathy Study focal laser treatment in 86 participants with diabetic macular edema. The primary outcome is change in visual acuity of ≥15 letters from baseline, and the secondary outcomes include a 50% reduction in the retinal thickening of diabetic macular edema measured by optical coherence tomography and a 50% reduction in leakage severity on fluorescein angiography. Visual acuity and retinal thickening data from >2 years of follow-up did not show evidence of differences between the medical and laser treatments. However, participants assigned to the celecoxib group were more likely to have a reduction in fluorescein leakage when compared with the placebo group (odds ratio = 3.6; P < 0.01). This short-term study did not find large visual function benefits of treatment with celecoxib or diode laser compared with those of standard laser treatment. A suggestive effect of celecoxib in reducing fluorescein leakage was observed.