Diabetic Macular Edema Clinical Trial
Official title:
Evaluation on Efficacy of Topical Nepafenac as Supplement Therapy in the Treatment of Diabetic Macular Edema
Diabetic macular edema (DME) is a major cause of visual loss in patients with diabetes
mellitus. The standard treatment is with focal/grid laser therapy. Topical nepafenac was
used as an adjunct therapy for treatment of DME.
The aim of this study is to compare the difference of best corrected visual acuity (BCVA)
and central macular thickness (CMT) at 3 months post treatment between combination therapy
of laser and topical nepafenac and laser monotherapy in patients with DME.
Diabetes mellitus with its systemic complications has been an enormous health treat to the
world population today. In the US, the ophthalmic related complications has been estimated
to cause up to 4.2 million (28.5%) people in 2005 till 2008 to suffer from blindness. One of
the most common causes of visual acuity loss in patients with diabetes mellitus is diabetic
macular edema (DME).
The gold standard of treatment for clinically significant macular edema (CSME), a form of
DME, is through focal and grid laser as shown by the Early Treatment Diabetic Retinopathy
Study. The development of newer drugs such as anti vascular endothelial growth factors anti
(VEGFs), an alternative to laser treatment, has become a topic of interest in the recent
years. Other alternative to treatment of DME is steroid such as triamcinolone injection and
dexamethasone injections. However, both anti VEGFs and steroids are expensive and not
readily available in all centres. Both types of medications require repeated treatment and
the route of administration through intravitreal also poses risk of endophthalmitis, lens
injury, retinal detachment, vitreous hemorrhage, increase in intraocular pressure and
cataract.
The pathophysiology of DME is not fully understood yet. It was suggested that it is likely
to be a chronic low-grade inflammation. Through this theory, topical non-steroidal
anti-inflammatory drugs (NSAIDs) have been used to treat DME. The investigators postulate
that the addition of topical NSAIDs in patients receiving standard treatment of laser
therapy may help to improve the outcome of patients with DME. It has the advantage of no
needles involved, convenient, easy to use and minimal side effects. The aim of this study is
to evaluate the outcome of visual acuity and macular thickness at 3 months post treatment
between laser monotherapy and combination of laser and topical nepafenac in DME.
;
Allocation: Randomized, Endpoint Classification: Safety/Efficacy Study, Intervention Model: Parallel Assignment, Masking: Single Blind (Investigator), Primary Purpose: Treatment
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