First Author: J.Luttrull USA
Co Author(s): J. Samples D. Kent B. Lum
Back to previous
To determine the effect of panmacular subthreshold diode micropulse laser (SDM) on optic nerve function in eyes with glaucomatous optic neuropathy (GON) due to primary open angle glaucoma (POAG).
A private vitreoretinal subspecialty practice (JKL).
A medical records review identified all patients with advanced POAG evaluated by visually evoked potential (VEP) testing both before and after SDM treatment. Other testing included automated Omnifield resolution perimetry (ORP).
88 eyes of 48 consecutive patients were included for study, 20 male and 28 female, aged 57-94 (avg. 79). All patients had glaucomatous optic nerve cupping and/or glaucomatous visual field loss prior to treatment. Pretreatment, IOPs ranged 6-23mm Hg (avg. 13) on 0-3 (avg. 1.6) medications. 33 eyes had had prior glaucoma surgery. Snellen visual acuities (VA) ranged 20/15 to count fingers (median 20/60). Prior to treatment, both VEPs and ORPs of all eyes were abnormal. Following panmacular SDM, VA and IOP were unchanged, while VEP amplitudes (p=0.001) and automated perimetry by ORP (p<0.0001) were significantly improved. There were no adverse treatment effects.
Improved VEP amplitudes demonstrate a significant neuroprotective effect from panmacular SDM. These improvements in optic nerve function were accompanied by significant improvements in visual function. All improvements were achieved without concomitant IOP lowering. Further study is will determine if SDM neuroprotection might aid the clinical management of glaucoma and other retinal neurodegenerative diseases.