PRELIMINARY ASSESSMENT OF CELECOXIB AND MICRODIODE PULSE LASER TREATMENT OF DIABETIC MACULAR EDEMA

Authors:
  • JKJonghyeon Kim
    Jonghyeon Kim
  • HCHanna R. Coleman
    Hanna R. Coleman
  • LALloyd Paul Aiello
    Lloyd Paul Aiello
  • GFGary Fish
    Gary Fish
  • MIMichael Ip
    Michael Ip
  • JHJulia A. Haller
    Julia A. Haller
  • MFMaria Msc Figueroa
    Maria Msc Figueroa
  • DMDaniel Martin
    Daniel Martin
  • DCDavid Callanan
    David Callanan
  • RARobert Avery
    Robert Avery
  • KHKeri Msc Hammel
    Keri Msc Hammel
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Abstract
Purpose: 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. Methods: 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. Results: 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). Conclusion: 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.

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