Focal Laser Photocoagulation in Non-Center Involved Diabetic Macular Edema
Medical hypothesis discovery and innovation in ophthalmology,
Vol. 3 No. 1 (2014),
1 March 2014
,
Page 9-16
Abstract
This study was performed to evaluate the functional and anatomic outcomes of focal macular laser photocoagulation in eyes with non-center involved macular edema (non-CI ME). Forty-nine eyes of 43 patients with non-CI ME were included. Focal macular laser photocoagulation was conducted on twenty-nine eyes of 25 patients, while 20 eyes of 18 patients with non-CI ME were followed without treatment and served as the control group. Data relating to best corrected visual acuity (BCVA; Early Treatment Diabetic Retinopathy Study) and central subfield thickness (CST), inner zone thickness (IZT), outer zone thickness (OZT), and total macular volume (TMV) as determined by optical coherence tomography (OCT) were collected and compared between the groups. At 12 months, VA decreased by a mean of 0.4 letters in the treatment group and 3.3 letters in the control group (p=0.03). Gain in VA ≥5 letters was noted in 6 (21%) of the eyes in the treatment group versus 1 (5%) eye in the control group (p=0.12). At 12 months, average IZT decreased by 22.6 microns in the treatment group and increased by 10.9 microns in the control group (p<0.001). The treatment group revealed significant reduction in CST, average OZT, and TMV as compared to the control group at 12 months (all p<0.05).Generally, focal laser photocoagulation may have more favourable visual outcomes in this specific group of diabetic patients than does observation. In addition, focal laser treatment provided better outcomes with improvement in OCT parameters as compared to the control group.References
Klein R, Klein BE, Moss SE, Davis MD, DeMets DL. The Wisconsin epidemiologic study of diabetic retinopathy. IV. Diabetic macular edema. Ophthalmology. 1984 Dec;91(12):1464-74. PMID: 6521986
Photocoagulation for diabetic macular edema. Early Treatment Diabetic Retinopathy Study Report Number 1. Early Treatment Diabetic Retinopathy Study Research Group.Arch Ophthalmol. 1985 Dec;103(12):1796-806. PMID: 2866759
Diabetic Retinopathy Clinical Research Network, Browning DJ, Glassman AR, Aiello LP, Beck RW, Brown DM, Fong DS, Bressler NM, Danis RP, Kinyoun JL, Nguyen QD, Bhavsar AR, Gottlieb J, Pieramici DJ, Rauser ME, Apte RS, Lim JI, Miskala PH. Relationship between optical coherence tomography-measured central retinal thickness and visual acuity in diabetic macular edema. Ophthalmology. 2007 Mar;114(3):525-36. PMID: 17123615
Bandello F, Cunha-Vaz J, Chong NV, Lang GE, Massin P, Mitchell P, Porta M, Prünte C, Schlingemann R, Schmidt-Erfurth U. New approaches for the treatment of diabetic macular oedema: recommendations by an expert panel. Eye (Lond). 2012 Apr;26(4):485-93. PMID: 22241014
Treatment techniques and clinical guidelines for photocoagulation of diabetic macular edema. Early Treatment Diabetic Retinopathy Study Report Number 2. Early Treatment Diabetic Retinopathy Study Research Group.Ophthalmology. 1987 Jul;94(7):761-74. PMID: 3658348
Davis MD, Bressler SB, Aiello LP, Bressler NM, Browning DJ, Flaxel CJ, Fong DS, Foster WJ, Glassman AR, Hartnett ME, Kollman C, Li HK, Qin H, Scott IU; Diabetic Retinopathy Clinical Research Network Study Group. Comparison of time-domain OCT and fundus photographic assessments of retinal thickening in eyes with diabetic macular edema. Invest Ophthalmol Vis Sci. 2008 May;49(5):1745-52. PMID: 18316700
Vemala R, Koshy S, Sivaprasad S. Qualitative and quantitative OCT response of diffuse diabetic macular edema to macular laser photocoagulation. Eye (Lond). 2011 Jul;25(7):901-8. PMID: 21494279
Gallego-Pinazo R, Suelves-Cogollos AM, Dolz-Marco R, Arevalo JF, GarcÃa-Delpech S, Mullor JL, DÃaz-Llopis M. Macular laser photocoagulation guided by spectral-domain optical coherence tomography versus fluorescein angiography for diabetic macular edema. Clin Ophthalmol. 2011;5:613-7. PMID: 21654890
Photocoagulation for diabetic macular edema: Early Treatment Diabetic Retinopathy Study Report Number 4. The Early Treatment Diabetic Retinopathy Study Research Group.Int Ophthalmol Clin. 1987 Winter;27(4):265-72. PMID: 3692708
Diabetic Retinopathy Clinical Research Network, Bressler NM, Miller KM, Beck RW, Bressler SB, Glassman AR, Kitchens JW, Melia M, Schlossman DK. Observational study of subclinical diabetic macular edema. Eye (Lond). 2012 Jun;26(6):833-40. PMID: 22441027
Writing Committee for the Diabetic Retinopathy Clinical Research Network, Fong DS, Strauber SF, Aiello LP, Beck RW, Callanan DG, Danis RP, Davis MD, Feman SS, Ferris F, Friedman SM, Garcia CA, Glassman AR, Han DP, Le D, Kollman C, Lauer AK, Recchia FM, Solomon SD. Comparison of the modified Early Treatment Diabetic Retinopathy Study and mild macular grid laser photocoagulation strategies for diabetic macular edema. Arch Ophthalmol. 2007 Apr;125(4):469-80. PMID: 17420366
Schatz H, Madeira D, McDonald HR, Johnson RN. Progressive enlargement of laser scars following grid laser photocoagulation for diffuse diabetic macular edema. Arch Ophthalmol. 1991 Nov;109(11):1549-51. PMID: 1755735
Dorin G. Evolution of retinal laser therapy: Minimum intensity photocoagulation (mip). Can the laser heal the retina without harming it? Semin Ophthalmol. 2004 Mar-Jun;19(1-2):62-8. PMID: 15590536
Early photocoagulation for diabetic retinopathy. Early Treatment Diabetic Retinopathy Study Report Number 9. Early Treatment Diabetic Retinopathy Study Research Group. Ophthalmology. 1991 May;98(5 Suppl):766-85. PMID: 2062512
Scott IU, Danis RP, Bressler SB, Bressler NM, Browning DJ, Qin H; Diabetic Retinopathy Clinical Research Network. Effect of focal/grid photocoagulation on visual acuity and retinal thickening in eyes with non-center involved clinically significant diabetic macular edema. Retina. 2009 May;29(5):613-7. PMID: 19373126
- Abstract Viewed: 3242 times
- Full text PDF Downloaded: 3460 times