The aim of this study was to compare the functional and structural effects of Ranibizumab versus macular laser treatment in patients with diabetic macular oedema. It was a single centre, prospective, randomised, single masked clinical trial spanning a 48 week period. Thirty-three eyes of 33 patients with centre involving diabetic macular oedema were included, with best corrected visual acuity of 55-79 ETDRS letters at baseline. At baseline they were randomised 2:1 to either three loading doses of Ranibizumab with re-treatment as required every four weeks or macular laser, which was repeated every 12 weeks as required. The outcome measures were divided into a) structural outcomes, such as greatest linear dimension and area of foveal avascular zone, capillary drop out grade, and morphologic characteristics on spectralis OCT and b) functional outcomes, such as visual acuity, retinal sensitivity on microperimetry, electroretinograms and colour contrast sensitivity. They were reported at 12, 24 and 48 weeks. The results showed that the Ranibizumab group had gained 6.0 letters, had improved colour contrast thresholds, better retinal sensitivity and improvements in electrophysiologic function, whereas the laser group had lost 0.9 letters. Ranibizumab was also superior in improving the retinal thickness and structure in diabetic macular oedema, with no signs of progressive ischaemia. The authors therefore concluded that Rabibizumab was indeed superior to laser therapy in the treatment of diabetic macular oedema. They also felt that their comprehensive methodology could be adopted for future studies. 

A randomized trial to assess functional and structural effects of Ranibizumab versus laser in diabetic macular edema (the LUCIDATE Study).
Comyn O, Sivaprasad S, Peto T, et al.
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Efrosini Papagiannuli

Birmingham and Midland Eye Centre, Birmingham, UK

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