METHODS: From December 2014 to August 2015, synchronous PDR patients with macular edema were divided into two groups. Thirty patients(48 eyes)were treated with Ranibizumab and laser, and 28 patients(45 eyes)were treated with laser alone. In the combined treatment group, FFA was reexamined 1wk after intravitreal injection of Ranibizumab. The patient then received panretinal photocoagulation(PRP). PRP was performed in the laser group alone. The best corrected visual acuity(BCVA)at 1, 4 and 8wk after treatment was observed and recorded. Macular thickness was measured by OCT.

RESULTS: The BCVA and macular thickness were significantly different between the two groups at 1, 4 and 8wk after treatment(P<0.05). In the laser alone group, the visual acuity decreased and the thickness of the macular thickness increased after 1wk. After treated 4 and 8wk, visual acuity improved, macular thickness decreased. After 1wk of intravitreal injection, FFA showed retinal leakage improvement in all eyes in the combined treatment group, with neovascularization retracted in varying degrees.

CONCLUSION:Ranibizumab combined with photocoagulation, can improve early vision, and reduce macular edema. Anti-VEGF therapy and photocoagulation may play a synergistic role to some extent. Drugs antagonized VEGF, improved macular edema and microvascular function. It can enhance the laser effect.Effective photocoagulation can further improve retinal ischemia and hypoxia, inhibit the excessive expression of VEGF.