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Laser Best for Diabetic Macular Edema

Study: Laser Therapy Trumps Steroid Injections in the Long Run
By Miranda Hitti
WebMD Health News
Reviewed by Louise Chang, MD

Aug. 6, 2008 -- Laser treatment may trump steroid injections at treating diabetic macular edema, a complication of diabetes that can impair vision.

That news comes from a head-to-head test of laser therapy, which is an established treatment for diabetic macular edema, and eye injections of a steroid called triamcinolone acetonide.

Steroid injections have become widely used to treat diabetic macular edema in the last decade, the researchers note in September's edition of Ophthalmology.

The study included 693 adults with type 1 or type 2 diabetes and diabetic macular edema. Each patient got one eye treated with laser therapy, a higher dose of steroid injected into the eye, or a lower-dose steroid injection.

During the two-year study, the patients repeated their treatments as needed and got their vision checked regularly.

Four months into the study, patients in the higher-dose steroid shot group had the best average scores on a vision test. But at the end of the two-year period, the laser group had better vision and fewer side effects than either steroid group; there was no difference at the end of the study between the two steroid doses.

"Many of the investigators, including myself, were surprised by the results," David Brown, MD, ophthalmologist and retina specialist at The Methodist Hospital in Houston, says in a news release. "We're continually researching new treatments, but sometimes the tried and true methods are still the best course. These findings substantiate the importance of laser treatment in the management of diabetic macular edema."

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