Comparison of short-pulse subthreshold and infrared micropulse macular laser photocoagulation for diabetic macular edema

Session Details

Session Title: Free Paper Session 24: Vascular Diseases & Diabetic Retinopathy VII

Session Date/Time: Sunday 10/09/2017 | 10:00-11:30

Paper Time: 10:42

Venue: Room 117

First Author: : I.Kozak UNITED ARAB EMIRATES

Co Author(s): :    A. Barki   L. Ibrahim   P. Schatz   R. High   D. Do   Q. Nguyen              

Abstract Details

Purpose:

Non-damaging (invisible) retinal photocoagulation seems to be an effective treatment option for diabetic macular edema (DME). The aim of the study was to assess both anatomic and functional outcomes between short-pulse

Setting:

Tertiary care eye hospital King Khaled Eye Specialist Hospital, Riyadh, Saudi Arabia.

Methods:

A prospective interventional study. Area Centralis contact lens (1.06x magnification) after application of topical anesthesia was used for treatment in all patients. Patients in the micropulse group were treated with the 810-nm diode micropulse scanning laser TxCell™ (IRIDEX Corporation, Mountain View, CA, USA). Laser was applied in a confluent mode (low intensity/high density) to the entire area of the macular edema and leakage as imaged by OCT and fundus fluorescein angiography. Patients in the short-pulse group were treated with grid pattern laser with 20ms pulse PASCAL laser 532nm (TopCon Medical Laser Systems, Tokyo, Japan) with EndPoint algorithm, which was either 30% or 50% of testing burn with one burn width apart. Repeated measures ANOVA model was used for statistical analysis.

Results:

There were 27 patients (44 eyes) in the micropulse group, 26 patients (54 eyes) in the EndPoint 50% group and 12 patients (18 eyes) in the EndPoint 30% group. The follow-up was 6 months in all patients and there were no adverse events during laser treatment. Foveal thickness for the whole cohort at baseline was 378.2±51.7 microns, at 3 months 347.2±61.3 microns (p=0.002) and 346.0±24.6 microns at the final follow-up (p=0.027). BCVA for the whole cohort (logMAR) at baseline was 0.451 (Snellen equivalent 20/56), at 3 months 0.495 (Snellen equivalent 20/62)(p=0.053) and 0.494 (Snellen equivalent 20/62) at the last follow-up (p=0.052).

Conclusions:

Short-pulse system may yield more reduction in edema while infrared micropulse system may yield slightly better functional outcomes. Overall treatment effect can be counteracted by significant amount of pre-treatment tissue edema.

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