title: Changes in vision related quality of life in patients with diabetic macular edema: ranibizumab or laser treatment?
abstract: OBJECTIVE
  To compare the changes in vision related quality of life (VR-QoL) in patients with diabetic macular edema (DME) undergoing intravitreal ranibizumab (IVR) injection or focal/grid laser.
  
  
  METHODS
  In this prospective study, 70 patients with clinically significant macular edema (CSME) were randomized to undergo IVR injection (n=35) and focal/grid laser (n=35). If necessary, the laser or ranibizumab injections were repeated. Distance and near visual acuities, central retinal thickness (CRT) and The 25-item Visual Function Questionnaire (VFQ-25) were used to measure the effectiveness of treatments and VR-QoL before and after 6 months following IVR or laser treatment.
  
  
  RESULTS
  The demographic and clinical findings before the treatments were similar in both main groups. The improvements in distance and near visual acuities were higher in IVR group than the laser group (p<0.01). The reduction in CRT in IVR group was higher than that in laser treatment group (p<0.01). In both groups, the VFQ-25 composite score tended to improve from baseline to 6 months. And at 6th month, the changes in composite score were significantly higher in IVR group than in laser group (p<0.05). The improvements in overall composite scores were 6.3 points for the IVR group compared with 3.0 points in the laser group. Patients treated with IVR and laser had large improvements in composite scores, general vision, near and distance visual acuities in VFQ-25 at 6 months, in comparison with baseline scores, and also mental health subscale in IVR group.
  
  
  CONCLUSIONS
  Our study revealed that IVR improved not only visual acuity or CRT, but also vision related quality of life more than laser treatment in DME. And these patient-reported outcomes may play an important role in the treatment choice in DME for clinicians.
authors: Akdeniz University, Department Of Ophthalmology,Antalya,Turkey. Electronic address: drelifbetul@gmail.com.
authors: Elif Betul
authors: EB
authors: Turkoglu
authors: Sakarya University Medical Education and Research Hospital, Sakarya,Turkey. Electronic address: drerkancelik@yahoo.com.
authors: Erkan
authors: E
authors: Celık
authors: Sakarya University Medical Education and Research Hospital, Sakarya,Turkey. Electronic address: nilgun_ozkan@yahoo.com.
authors: Nilgun
authors: N
authors: Aksoy
authors: Sakarya University Medical Education and Research Hospital, Sakarya,Turkey. Electronic address: drozlemtas@yahoo.com.
authors: Ozlem
authors: O
authors: Bursalı
authors: Sakarya University Medical Education and Research Hospital, Sakarya,Turkey. Electronic address: turgayucak10@gmail.com.
authors: Turgay
authors: T
authors: Ucak
authors: Sakarya University Medical Education and Research Hospital, Sakarya,Turkey. Electronic address: drelifbetul@yahoo.com.
authors: Gursoy
authors: G
authors: Alagoz
mesh_terms: D000368:Aged; D003930:Diabetic Retinopathy / Q000188:drug therapy* / Q000503:physiopathology / Q000601:surgery*; D005260:Female; D006801:Humans; D058449:Intravitreal Injections; D017075:Laser Coagulation; D008269:Macular Edema / Q000188:drug therapy* / Q000503:physiopathology / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D011788:Quality of Life; D000069579:Ranibizumab / Q000008:administration & dosage / Q000627:therapeutic use*; D011795:Surveys and Questionnaires; D016896:Treatment Outcome; D014785:Vision, Ocular / Q000187:drug effects / Q000502:physiology* / Q000528:radiation effects; D014792:Visual Acuity / Q000187:drug effects / Q000528:radiation effects
chemical_list: D000069579:Ranibizumab
keywords: Diabetes; Laser; Quality of life; RETİNOPATHY; Ranibizumab