The effect of recurrent povidone-iodine usage on conjunctival flora in diabetic patients undergoing intravitreal injections

Purpose: The purpose was to evaluate the change in the microbiological profile of diabetic patients undergoing intravitreal injections for diabetic macular edema. Methods: Patients were included in this prospective study when referred for the first time for intravitreal injection to treat diabetic macular edema. For each patient, conjunctival cultures were taken from the lower fornix of each eye prior to the povidone-iodine application and the intravitreal injection. An additional culture was taken from the treated eye 20 min after the injection. The same culture protocol was used for the two following injections of these patients. A later conjunctival culture was also taken a month after the last injection. Results: Twenty-one eyes of 21 patients were included. The mean duration of diabetes was 13.7 ± 7.9 years. Prior to the first intravitreal injection, 33% of cultures were positive. Prior to the third intravitreal injection, 26% of cultures were positive ( p = 0.63), and 1 month after the last injection, 18% of cultures were positive ( p = 0.495). The mean HbA1C was 8.1% ± 1.7%. HbA1C of patients with positive cultures was 8.0% ± 1.1% at the first intravitreal injection and 8.2% ± 1.0% at the third intravitreal injection. This was compared with HBA1C in eyes with negative cultures: 7.4% ± 1.2% ( p = 0.45) and 7.1% ± 1.0% ( p = 0.14), respectively. Conclusion: Repeated intravitreal injection for diabetic macular edema with application of povidone-iodine 5% in diabetic patients did not lead to a significant change in the percentage of positive conjunctival cultures. Patients with higher HbA1C had a slight, non-statistically significant trend for positive cultures.

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Treatment results of nondamaging retinal laser therapy in diabetic macular edema

Therapeutic Advances in Ophthalmology ◽

10.1177/25158414211063284 ◽

2022 ◽

Vol 14 ◽

pp. 251584142110632

Author(s):

Burcu P. Gültekin

Keyword(s):

Visual Acuity ◽

Macular Edema ◽

Laser Therapy ◽

Diabetic Macular Edema ◽

Intravitreal Injections ◽

Diabetic Patients ◽

Efficacy And Safety ◽

Anti Vegf ◽

Significant Difference ◽

The Mean

Background: Subthreshold nondamaging retinal laser therapy (NRT) provides a greater safety profile than conventional laser methods, but more data is needed on the efficacy and safety of subthreshold NRT in diabetic macular edema. Purpose: To evaluate the efficacy and safety of NRT for the treatment of clinically significant macular edema (CSME) that is partially responsive or resistant to intravitreal anti-vascular endothelial growth factor (anti-VEGF) treatment. Methods: This was a retrospective case series study. Fifty eyes of 38 diabetic patients with CSME previously treated with at least 6-monthly intravitreal bevacizumab injections with/without intravitreal Ozurdex therapy were evaluated. The patients received 577-nm yellow wavelength laser therapy with PASCAL laser system (Topcon Medical Laser Systems, Santa Clara, CA, USA). Best-corrected visual acuity (BCVA) and central subfield thickness (CST) were evaluated before and 1, 3, 6, 12 and 24 months after laser treatment. Results: Baseline mean CST was 368.06 ± 86.9 µm. The mean CST values at the 1-, 3-, 6-, 12-, and 24-month visits were 336.93 ± 79.8, 352.40 ± 113.5, 336.36 ± 109.3, 325.10 ± 104 µm, and 310.08 ± 84.7 µm, respectively. The mean CST decreased significantly at the first ( p = 0.002) and second year visits ( p < 0.001) when compared with pretreatment values. Although visual acuity was improved at the first year compared with baseline, this difference was not statistically significant ( p = 0.03). There was no significant difference in visual acuities between pretreatment and posttreatment visits. During 24-month follow-up, while 37 eyes were treated with [mean: 5.7 ± 3.4 (1–14)] intravitreal anti-VEGF injections, 3 eyes were administered single-dose intravitreal steroids. Additional intravitreal injections were not required in 10 (20%) eyes. Conclusion: NRT is effective by itself or in combination with anti-VEGF agents in diabetic macular edema that is partially responsive or resistant to previous intravitreal injections. T role in treating this disorder should be assessed in more detail with prospective controlled studies.

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Patient Preferences with Regard to Laser versus Intravitreal Injections in the Treatment of Diabetic Macular Edema

Journal of Ophthalmology ◽

10.1155/2017/7398470 ◽

2017 ◽

Vol 2017 ◽

pp. 1-4 ◽

Cited By ~ 1

Author(s):

Lauren Mason ◽

Jason N. Crosson ◽

John O. Mason ◽

Gerald McGwin

Keyword(s):

Macular Edema ◽

Diabetic Macular Edema ◽

Treatment Effectiveness ◽

Intravitreal Injections ◽

Treatment Preference ◽

Treatment Preferences ◽

Diabetic Patients ◽

The Mean ◽

Injection Anxiety

Purpose. To identify treatment preferences of patients with diabetic macular edema (DME) having undergone laser and intravitreal injections. Methods. Patients with DME who received lasers and injections were surveyed, measuring preferences toward specific treatments. 66/210 diabetic patients met the criteria for our survey assessing preference for lasers and/or injections, incorporating demographics and treatment preference questions. Outcome measures included treatment preference (laser or injections), how often patients are willing to be treated, and how much vision they will sacrifice to avoid being treated every month. Results. 66 patients completed the survey. The mean diabetes duration was 20.7 years, the mean retina follow-up was 4.4 years, and patients received a mean of 4.82 lasers and 4.86 injections. 56% preferred injections, 33% preferred laser, and 11% had no preference. Regarding treatment effectiveness, 38% found no difference, 36% chose laser, and 25% chose injections. Regarding anxiety, 56% reported injection anxiety. While 50% versus 38% reported that laser was easier than injections. 91% would give up zero lines on the eye chart, and 76% would come in 12 times yearly for treatment to maintain vision. Conclusion. Patients with DME have no profound preference regarding laser versus intravitreal injections but prefer aggressive treatment and are unwilling to sacrifice vision for less visits.

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The Effect of Ranibizumab Loading Treatment on Vision-Related Quality of Life in Diabetic Macular Edema

Clinics and Practice ◽

10.3390/clinpract11030081 ◽

2021 ◽

Vol 11 (3) ◽

pp. 659-670

Author(s):

Hatice Daldal ◽

Mustafa Turkyilmaz ◽

Melike Balikoglu Yilmaz ◽

Ufuk Berberoglu

Keyword(s):

Quality Of Life ◽

Macular Edema ◽

Intravitreal Injection ◽

Diabetic Macular Edema ◽

Macular Thickness ◽

Loading Dose ◽

The Third ◽

Related Quality ◽

Composite Scores

Aims: To investigate the changes in vision-related quality of life after a loading dose of three consecutive intravitreal ranibizumab (IVR) injections in patients with unilateral diabetic macular edema (DME). Materials and Methods: Fifty-two eyes of 52 patients who received IVR injections in only one eye with DME were included in our study. The following characteristics of the patients were recorded: gender, education status, marital status, work status, presence of chronic disease. The changes in best-corrected visual acuity (BCVA) and central macular thickness (CMT) were evaluated at baseline (before treatment) and 1 month after the third intravitreal injection (after treatment). Patients were administered the Turkish form of the National Eye Institute 25-Item Visual Functions Questionnaire (NEI VFQ-25 TR). The quality of life scores assessed by the NEI VFQ-25 TR, the BCVA, intraocular pressure (IOP), and CMT measurements were compared at baseline (before treatment) and 1 month after the third intravitreal injection (after treatment). Results: We enrolled 52 patients (25 females, 27 males) in our study; mean age was 64.35 ± 9.26 years. After treatment, BCVA improved significantly (p = 0.001), and macular thickness decreased significantly (p < 0.001). All NEI VFQ-25 TR subscale scores were significantly higher after treatment (p < 0.05). However, no significant correlation was found between the change in BCVA and CMT and the change in NEI VFQ-25 TR subscale and composite scores. The increase in near activities scores was significantly higher in males (p = 0.020) and in the retired group (p = 0.022). There were no significant differences in the changes in NEI VFQ-25 TR subscale and composite scores in relation to educational status. Discussion: Significant improvements in BCVA, macular edema, and vision-related quality of life were found in DME patients who received IVR injections with a loading dose, as shown by the NEI VFQ-25 TR. Interestingly, a significant improvement in quality of life was observed even though the patients could see well with the fellow eye. In conclusion, the NEI VFQ-25 TR is a useful scale to evaluate the changes in visual function and psychosocial characteristics of DME patients after treatment.

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Pars Plana Vitrectomy versus Intravitreal Injection of Ranibizumab in the Treatment of Diabetic Macular Edema Associated with Vitreomacular Interface Abnormalities

Journal of Ophthalmology ◽

10.1155/2021/6699668 ◽

2021 ◽

Vol 2021 ◽

pp. 1-10

Author(s):

Hassan Elkayal ◽

Ahmed M. Bedda ◽

Hesham El-Goweini ◽

Ahmed A. Souka ◽

Amir Ramadan Gomaa

Keyword(s):

Macular Edema ◽

Intravitreal Injection ◽

Diabetic Macular Edema ◽

Pars Plana Vitrectomy ◽

Vision Loss ◽

Group I ◽

Pars Plana ◽

Vitreomacular Interface ◽

The Mean ◽

Group Ii

Purpose. To compare the efficacy of pars plana vitrectomy (PPV) versus intravitreal injection (IVI) of ranibizumab (RBZ) in the treatment of diabetic macular edema (DME) associated with vitreomacular interface abnormalities (VMIA). Methods. The records of patients presenting with DME and VMIA throughout 2016 to 2018 were retrospectively analyzed. The patients were divided into 2 groups: group I received IVIs of RBZ and group II underwent PPV with internal limiting membrane peeling. The main outcome measures were the change in the LogMAR corrected distance visual acuity (CDVA) and central subfield thickness (CSFT) on optical coherence tomography over 6 months. Results. At 6 months, mean CDVA improved by 0.22 ± 0.21 in group I patients p < 0.001 , while in group II, it improved only by 0.09 ± 0.22 p < 0.115 . Fifty-five percent of group I and 60% of group II patients had stable CDVA (within 2 lines from baseline) at 6 months. Significant improvement in vision (gain of 2 or more lines) was seen in 45% and 30%, respectively. Worsening of vision (loss of 2 or more lines) was seen only in 2 patients in group II, but none in group I. The mean CSFT improved significantly in both groups (by 162 µ and 216 µ, respectively; p < 0.001 ). The mean CSFT at 6 months was similar in both groups (354 µ and 311 µ, respectively; p = 0.172 ). Conclusions. Both treatments resulted in anatomical improvement of DME with concurrent VMIA. Visual improvement was more pronounced in the IVI group, although this may have been affected by other confounding factors.

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Subthreshold micropulse laser adjuvant to bevacizumab versus bevacizumab monotherapy in treating diabetic macular edema: one- year- follow-up

Therapeutic Advances in Ophthalmology ◽

10.1177/25158414211040887 ◽

2021 ◽

Vol 13 ◽

pp. 251584142110408

Author(s):

Leila El Matri ◽

Ahmed Chebil ◽

Khaled El Matri ◽

Yousra Falfoul ◽

Zouheir Chebbi

Keyword(s):

Macular Edema ◽

Diabetic Macular Edema ◽

Intravitreal Injections ◽

Control Group ◽

Diabetic Patients ◽

Micropulse Laser ◽

Treatment Naïve ◽

The Difference ◽

Retrospective Comparative Study

Purpose: To compare the therapeutic impact of combining intravitreal injections of bevacizumab (IVB) with micropulse laser (MPL) in central diffuse diabetic macular edema (DME) versus IVB monotherapy during 12 months follow-up. Methods: We conducted a retrospective comparative study of 98 treatment-naive eyes (63 patients) with central diffuse DME. The first group of patients (IVB + MPL group, n = 49) was treated with 3 monthly IVB followed by MPL within 1 week after the third injection. Patients were then followed and treated on a pro re nata (PRN) basis, with MPL retreatment if necessary. The changes in best-corrected visual acuity (BCVA), central macular thickness (CMT), number of IVB injections and MPL sessions were evaluated at 4, 8, and 12 months. A control group of diabetic patients with treatment-naive DME was treated with standard protocol of 3 monthly IVB as monotherapy then followed on a PRN basis (IVB group, n = 49). Statistic comparaison of BCVA, CMT, and IVB number variation was interpreted at 12 months between both groups. Results: In IVB + MPL group, baseline BCVA improvement was not significant at 4 and 8 months ( p = 0.90, p = 0.08), and was statistically significant ( p = 0.01) at 12 months. Mean CMT significantly decreased at 4, 8, and 12 months ( p < 0.01) in IVB + MPL group. The difference in BCVA (p = 0.091) and CMT (p = 0.082) variation at 12 months between both groups was not significant but the number of injections was significantly lower in IVB + MPL group (4.1 ± 1.5 injections) compared to IVB group (7.2 ± 1.3 injections) ( p < 0.005). Conclusion: Combining intravitreal injections of bevacizumab and MPL in the treatment of DME is effective and safe. This protocol may decrease the number of IVB and its frequency. It offers the advantage of lasting therapeutic response with fewer recurrences.

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Efficacy of posterior sub-Tenon’s capsule injection compared to intravitreal injection of triamcinolone acetonide for treatment of diabetic macular edema: A systematic review and meta-analysis

QJM ◽

10.1093/qjmed/hcab109.019 ◽

2021 ◽

Vol 114 (Supplement_1) ◽

Author(s):

Mohamed H Ibrahim ◽

Abdelrahman G Salman ◽

Azza M Said ◽

Mariam A Al-Feky ◽

Moustafa E Moustafa

Keyword(s):

Systematic Review ◽

Macular Edema ◽

Intravitreal Injection ◽

Triamcinolone Acetonide ◽

Diabetic Macular Edema ◽

Meta Analysis ◽

Significant Difference ◽

The Mean ◽

Iop Elevation

Abstract Background Diabetic macular edema (DME) is defined as a retinal thickening in one-disc diameter (DD) of the centre of the macula. It is a number of microvascular retinal changes that lead to blood–retinal barrier (BRB) disruption, causing leakage of fluid and plasma components into the inner and outer plexiform layers. Aim of the Work to conduct a systematic review and a meta-analysis estimating the efficacy and complications of posterior sub-Tenon’s capsule injection of triamcinolone acetonide (STTA) compared to intravitreal injection of triamcinolone acetonide (IVTA) for management of DME. Materials and Methods A comprehensive literature search was conducted using the databases Google scholar, PubMed, MEDS, web of science, EMBASE and Cochrane Library for published studies from 1 January 2000 to 1 September 2019.This meta-analysis included ten studies. They were randomized controlled clinical trials (RCTs), and about 343 patients with DME (469 eyes) participated in these studies. Results : This study demonstrated a statistically significant change in the mean of best corrected visual acuity (BCVA) improvement and central macular thickness (CMT) reduction in both groups when comparing the baseline to one- and three-month follow-ups after the injection, though with no statistically significant difference in the IVTA compared to the STTA group. At a six-month follow-up, both groups showed no significant differences in the BCVA and CMT compared to the baseline. Both groups showed no statistical differences in the BCVA or CMT over the follow-up periods. Regarding intraocular pressure (IOP) changes, the present study showed that the mean IOP was elevated in both groups at one- and three-month follow-ups after the injection compared to their baseline. There was a statistically significant difference between both groups at one and three-months. The IOP was more elevated in the IVTA compared to the STTA group. At a six-month follow-up, both groups showed no significant difference in the IOP elevation compared to the baseline. IOP elevation was the most reported adverse effect in all included studies. Cataract formation is also reported in some studies, though no other complications, such as endophthalmitis, vitreous hemorrhage (VH), and/or retinal detachment (RD), are reported in any of the studies. Conclusion : STTA injection has a comparable effect to the IVTA injection and carries a lower risk of intraocular complications. It is considered an easy, safe, and valid alternative to the intravitreal injection for the treatment of DME.

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Multifocal Electroretinogram, Central Macula Thickness and Visual Acuity in Diabetic Macular Edema Following Intravitreal Injection of anti-VEGF

International Journal of Retina ◽

10.35479/ijretina.2021.vol004.iss002.156 ◽

2021 ◽

Vol 4 (2) ◽

pp. 150

Author(s):

Syntia Nusanti ◽

Kirana Sampurna ◽

Ari Djatikusumo ◽

Anggun Rama Yudantha ◽

Joedo Prihartono

Keyword(s):

Visual Acuity ◽

Diabetic Retinopathy ◽

Macular Edema ◽

Intravitreal Injection ◽

Diabetic Macular Edema ◽

Proliferative Diabetic Retinopathy ◽

Diabetic Patients ◽

Post Injection ◽

Anti Vegf ◽

Sd Oct

Introduction : Diabetic Retinopathy (DR) is one of the major cause of visual acuity deterioration in diabetic patients. The loss of central visual acuity in diabetic patients are mainly due to macula edema, which is found in 29% diabetic patients with the over 20 years duration of disease. The aim of this study is to evaluate and investigate the possible correlation among changes of visual acuity (VA), central macular thickness (CMT) using Spectral Domain Optical Coherence Tomography (SD-OCT). Electrophysiological responses using multifocal electroretinography (MfERG) in diabetic macular edema (DME) following intravitreal injection of bevacizumab. Methods: Single arm clinical trial. Thirty-three eyes of 33 DME patients (16 non-proliferative diabetic retinopathy and 17 non-high-risk proliferative diabetic retinopathy), receives intravitreal bevacizumab 1,25mg. All patients underwent complete ophthalmic examination including ETDRS VA testing, Sixty-one scaled hexagon MfERG and SD-OCT scan at baseline, 1-week and 1-month post-injection. Components of the first order kernel (N1, N2 and P1) in central 2o were measured. Result : MfERG showed reduced P1 amplitude (P<0.05) at 1-week after injection followed by increased P1 amplitude (P>0.05) at 1-month after treatment as compared to the baseline in all subjects. There was 19% improvement CMT and 0.2Logmar VA improvement in 1-month post-injection compared to the baseline (P<005). This study showed no serious ocular adverse effects. There was no significant correlation between changes in visual acuity with changes in CMT or other MfERG parameters. Conclusion: Intravitreal injection bevacizumab resulting in improved VA, reduction in CMT and mild improvement in the MfERG responses. Although VA changes did not correlate with reduced CMT nor with improved responses of MfERG, the combined use of SD-OCT and MfERG may be used to evaluate macular function in DME patient with worsened visual acuity post anti-VEGF injection.

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CENTRAL MACULAR THICKNESS AFTER COMBINED THERAPY OF BEVACIZUMAB INTRAVITREAL INJECTION AND TOPICAL DICLOFENAC COMPARED WITH BEVACIZUMAB INTRAVITREAL INJECTION ALONE IN DIABETIC MACULAR EDEMA

International Journal of Retina ◽

10.35479/ijretina.2021.vol004.iss002.164 ◽

2021 ◽

Vol 4 (2) ◽

pp. 106

Author(s):

Melvina Nidya Sandra ◽

Yumni Shabrina ◽

Tri Wahyu Widayanti ◽

Retno Ekantini ◽

Agus Supartoto ◽

...

Keyword(s):

Macular Edema ◽

Intravitreal Injection ◽

Diabetic Macular Edema ◽

Macular Thickness ◽

Combination Group ◽

Central Macular Thickness ◽

Significant Difference ◽

The Mean ◽

Group 2 ◽

Group 1

Introduction: To evaluate whether the combination of diclofenac eye drops and bevacizumab intravitreal injection would provide additional benefits over bevacizumab alone in the treatment of naïve diabetic macular edema (DME). Methods: A total of 43 patients were enrolled consecutively and randomized into two groups to receive combination treatment with intravitreal bevacizumab and topical diclofenac (group 1) or bevacizumab alone (group 2). Group 1 patients received single bevacizumab intravitreal injection and got self-administered diclofenac eye drop four times daily for one month. Group 2 patients received single bevacizumab intravitreal injection alone. Outcome data were obtained from patient visits at baseline and at 1 month after bevacizumab intravitreal injection. All patients underwent measurement of best corrected visual acuity (BCVA), a complete eye examination, and measurement of central macular thickness (CMT). Result: The mean reduction in CMT in the combination group was 130.42±32.57 µm (p<0.01), while in the bevacizumab alone group the reduction was 141.38±45.27 µm (p<0.01), there is no significant difference between the two groups (p=0.866). The mean improvement of BCVA was 0.32±0.10 log Mar in the combination group and 0.26±0.12 in group 2, there is no significant difference between the two groups (p=0.691). There was no adverse ocular event in the two groups. Conclusion: In patients with naïve DME, adding diclofenac eye drop as adjuvant of bevacizumab intravitreal injection are less likely to have a meaningful effect on reducing the central macular thickness. Keywords: Diabetic macular edema, NSAID, diclofenac, anti-VEGF, bevacizumab, central macular thickness

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Switching to Ziv-aflibercept In Resistant Diabetic Macular Edema Non Responsive to Ranibizumab Injection

10.21203/rs.3.rs-586036/v1 ◽

2021 ◽

Author(s):

Amin E. Nawar ◽

Tamer Wasfy ◽

Heba M. Shafik

Keyword(s):

Macular Edema ◽

Intravitreal Injection ◽

Diabetic Macular Edema ◽

Low Income ◽

Glycated Hemoglobin ◽

Subretinal Fluid ◽

Diabetic Patients ◽

Vascular Endothelial ◽

Corrected Visual Acuity ◽

Endothelial Growth Factor

Abstract Background: Diabetic macular edema (DME) is a leading cause of visual loss in diabetic patients and is managed using multiple anti-vascular endothelial growth factor (VEGF) agents such as bevacizumab, ranibizumab and aflibercept. The present study evaluates effectiveness of intravitreal injection of ziv-aflibercept in resistant diabetic macular edema.Methods: This is a prospective interventional study that was carried out on 59 eyes of 40 diabetic patients with diabetic macular edema resistant to three prior consecutive ranibizumab injections. On all patients, thorough ophthalmic evaluation including optical coherence tomography was performed. In patients with persistent intraretinal or subretinal fluid, ziv- aflibercept 1.25 mg (0.05 ml) was administered by intravitreal injection monthly during the 6month study period from June to December 2019.Results: The central macular thickness (CMT) decreased significantly from 395.08±129.9 um at baseline to 282.39±95.278, 245.36±79.861 and 201.17±54.042 after one, three and six months of treatment respectively (p < 0.001). Best corrected visual acuity (BCVA) in log MAR units was significantly improved from 0.95±0.21 to 0.51±0.23 after six months (p = 0.001). After treatment, negative correlations were detected between age, number of injections, duration of DM and level of glycated hemoglobin (HbA1C) and variation of both CMT and BCVA. The only significant predictor for low final CMT after six months of injection was the CMT after three months of injection (p = 0.001).Conclusion: Ziv-aflibercept is a highly effective and safe drug in cases of DME resistant to previous ranibizumab injections especially in low-income countries.This study was retrospectively registered at clinicaltrials.gov (ID: NCT04290195) on 26-2-2020

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A study of therapeutic effects of 670 nm irradiation in different types of diabetic macular edema

Biomedical Photonics ◽

10.24931/2413-9432-2020-9-4-15-22 ◽

2021 ◽

Vol 9 (4) ◽

pp. 15-22

Author(s):

S. Ramin ◽

M. Ahadi ◽

A. Ebrahimi

Keyword(s):

Visual Acuity ◽

Diabetic Retinopathy ◽

Macular Edema ◽

Diabetic Macular Edema ◽

Retinal Thickness ◽

Central Retinal Thickness ◽

Diabetic Patients ◽

Therapeutic Effects ◽

Positive Effects ◽

The Mean

The purpose of this study was to investigate the therapeutic effects of 670 nm irradiation in patients with diabetic macular edema. In several studies, positive effects of red/near-infrared irradiation showed in a range of ocular diseases such as macular degeneration, macular edema, and retinitis pigmentosa. This study was conducted on forty five eyes of 26 diabetic patients with macular edema between the ages of 51 and 80.Measurement of visual acuity and slit lamp examination, funduscopy, and optical coherence tomography were performed in all subjects. None of the patients had proliferative retinopathy. We used a portable LED device (Warp 10, Quantum Devices) for treatment. Patients held this device at a distance of 3 cm from their eyes for 240 seconds for three months. Full ophthalmic examinations were repeated 1, 2, and 3 months after treatment.After 3 months, the mean visual acuity improved from 0.44 ± 0.38 log MAR to 0.27 ± 0.24 log MAR and vision increased by 1.52 ± 1.16 lines post treatment (р<0.001). The mean central macula thickness decreased from 381.49 ± 144.40 μm to 359.72 ± 128.84 μm (р=0.050). In patients with mild and moderate nonproliferative diabetic retinopathy, the mean central retinal thickness decreased 52.06 ± 67.78 μm and 39.27 ± 44.69 μm, respectively, but patients with severe type showed an increase of 34.93 ± 65.65 μm in the mean central retinal thickness (р<0.001). Also, the severity of macular edema had no effect on final outcomes (р>0.05). Photobiomodulation can positively affect diabetic macular edema, especially in patients with mild to moderate diabetic retinopathy.

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