First Author: G.Pacelli ITALY
Co Author(s): G. Macri' C. Pisano L. Baraggia A. Nucera S. Daniela V. Belloli
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Long term retrospective study assessing the efficacy of Pascal GML associated with SS in reducing central macular thickness (CMT) improving visual function in SDCME (CMT>400 microns) in NPDR without intravitreal injection. Assessing utility of angioOCT in retreating decisions.
Ss. Trinità Hospital Borgomanero ophthalmic department
28 eyes of 22 patients affected by SDCME. Mean FU: 25 months. GML was performed with Pascal Photocoagulator: focal laser of micro-aneurysms and a mild GML (mean spot 60µm; mean power 130 mw; 20 ms). SS was performed during follow up in 15 out of 28 eyes (100 micron spot and a mean power of 275 mw, 10 ms; SLS: 30% of the tirtrate power value). Re-treatments criteria guided by OCT, fluorescein angiography (FA) and angio-OCT. To assess the influence of metabolic control, patients entered 2 groups (cut-off Hba1c:7.50%). Group 1 (G1) >7.5%: 14 eyes; Group 2 (G2) <7.5%: 14 eyes. Each patient was evaluated with best corrected visual acuity (BCVA), SD-OCT, FA and in some recent cases with angio-OCT.
BCVA improved in 88% of patients. Mean percentual improvement of BCVA: 59% (G1 41%; G2 54%). Mean BCVA (LogMAR): Initial 0.45 ; final: 0.26. CMT improved in almost all patients (mean basal CMT:537 µm; final CMT:319 µm). Observing BCVA and CMT, we stress the importance of glico-metabolic control.
Despite the enthusiasm for intra-vitreal steroids and anti-VEGF treatments of SDCME, laser treatment remains an actual modality of care with proven longstanding efficacy. PL is a valid instrument to perform GML; minimizing laser scar it allows an optimal management of CSDME. Angio-OCT helps to identify leaking microaneurysm and is a valid alternative to FA to guide treatment.