First Author: M.Latalska POLAND
Co Author(s): A. Prokopiuk
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To evaluate the efficacy of subthreshold micropulse yellow (577 nm) laser photocoagulation in diffuse macular edema (DME) for diabetic macular edema.
Laser therapy has been replaced by anti-VEGF therapy in the treatment of diabetic macular edema. Is micropulse laser therapy can make a difference?
The examined group consisted of 46 females and 29 males, aged 26-83 years (mean age 67±8.0) with diffuse diabetic macular edema treated in Department of Vitreoretinal Surgery of Medical University of Lublin received 1 to 4 sessions of laser photocoagulation (IRIDEX OcuLight IQ 577nm) in two-months intervals, with a 5% duty cycle at an energy level. The laser exposure time was 20 ms and the spot diameter was 200 µm. Median duration of DM in treated group was 15±10 years (ranged 1-39), median glycated haemoglobin- HbA1c level was 7.3±0.96 (ranged 6.1-9.78%). The SD-OCT was performed to evaluate the central retinal thickness before treatment and in two month intervals. Further, we measured visual acuity for distance and reading vision.
The follow-up was 6 months. The baseline median BCVA was 0.20±0.27 and remained stable: 0.30±0.37 after 6 months (p=0.0019*). The median reading vision improved from 1.0±1.0 at baseline to 0.5±1.2 at final follow-up ( p=0.00042*). The median CRT at baseline was 500±205 µm and decreased significantly to 346±153 µm (p=0.00000*) at the final follow-up. Finally, no retinal damage was observed. We obtained statistically significant reduction in central retinal thickness, stabilization of visual acuity for distance and improving in reading visual acuity.
Subthreshold yellow micropulse laser showed short-term efficacy in the treatment of DME. It allows to obtain a therapeutic effect at lower level of energy, which limits the laser-induced heat to spread to adjacent tissues and avoids to demage the retinal layers.