Treating Diabetic Macular Edema by a Micropulse Laser – First Findings
Authors:
M. Závorková; L. Procházková
Authors‘ workplace:
Oční klinika UJEP, Krajská zdravotní a. s., Masarykova nemocnice Ústí nad Labem
primářka MUDr. Ivana Liehneová Ph. D.
Published in:
Čes. a slov. Oftal., 71, 2015, No. 5, p. 223-228
Category:
Original Article
Overview
Introduction:
Diabetic macular edema (DME) is the most common cause of a visus dicrease in patients suffering type 2 diabetes. DME originates in abnormal macula capillars permeability. This study presents the findings of observing patients with DME after by micropulse laser therapy with the wavelength of 577 nm.
Methods:
The study covers 23 eyes of 15 patients with focal or difuse DME. In all patients we performed a 577 nm micropulse laser therapy of the macula, proceeding by a technique of placing spots next to each other in the shape of EDTRS optotype letters. In average we performed 3 treatments per eye.
Results:
Best-corrected visual acuity (BCVA) was 61,8 of a letter at the beginning, 62,5 of a letter after 3 months, 59,5 of a letter after 6 months, 57,6 of a letter after 9 months and 59,2 of a letter after 12 months. The average difference between BVAC at the beginning and after a year was -2.7 of a letter. A T-test does shows statistically insignificant difference.
The average central retinal thickness (CRT) was 380,4 µm at the beginning, 368,1 µm after 3 months, 327,5 µm after 6 months, 329,2 µm after 9 months and 301,0 µm after 12 months. The difference between the average CRT at the beginning and after 12 months was -79,5 µm. A T-test shows statistically significant difference.
Discussion:
Our studied group reported visus improvement or stabilization in 61% of eyes and decrease or stabilization of DME in 83% of eyes. Without treatment a deterioration would occur due to the progressive nature of the disorder. Taking into account these results and relevant literature we resolved to change our treatment methods in favour of placing laser spots as close as possible. An evaluative study of this method will follow.
Conclusion:
In the studied group the average CRT improved and the average BCVA remained virtually equal. Treating DME by means of a micropulse laser has proven to be an effective method. It does not leave scars on retina and thus prevents creating scotoms. If the edema is higher or a resistent cyst occurs in the macula, it is recommended to combine laser and anti-VEGF therapies. In case of insufficient effects of a laser therapy there is a possibility of combining it with an anti-VEGF treatment.
Key words:
diabetic macular edema, laser treatment, micropulse laser
Sources
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OphthalmologyArticle was published in
Czech and Slovak Ophthalmology
2015 Issue 5
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