Anti-VEGF agents for the treatment of diabetic macular edema

Сергушев, С. Г.; Khomyakova, E.N.

doi:10.32364/2311-7729-2019-19-4-238-244

Cited by 2 publications

(1 citation statement)

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“…Кроме того, распространение тепла от лазеркоагулята на окружающую сетчатку формирует коллатеральную зону субпорогового термического воздействия. Тепловая активация пигментного эпителия увеличивает выработку фактора роста пигментного эпителия (pigment epithelium derived factor -PEDF), который обладает важным нейротрофическим действием и является антагонистом VEGF [6].…”

Section: актуальностьunclassified

Comparative quantitative assessment of the placement and intensity of laser spots for treating diabetic macular edema

Zamytskiy¹,

Золотарев²,

Карлова³

et al. 2021

Russian Journal of Clinical Ophthalmology

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Aim: to compare the uniformity and adequacy of the placement of laser spots after mono-impulse and pattern photocoagulation for diabetic macular edema (DME). Patients and Methods: fundus photographs of 83 patients (121 eyes) taken right after retinal photocoagulation for DME were analyzed. Group 1 included images of 63 eyes after pattern photocoagulation and group 2 included images of 58 eyes after mono-impulse photocoagulation. Laser burns of varying intensity based on LʹEsperance scale (including grade 0 burns that were not seen on fundus photos) were calculated. Grade 2 burns were considered optimal. The number of non-optimal laser burns placed on retinal hemorrhages, blood vessels, hard exudates or healthy retina was calculated. The uniformity of the position of laser spots was assessed by calculating the standard deviation from the average distance between laser spots. Results: the percentage of laser spots of optimal intensity was 31.85% in group 1 and 25.15% in group 2. The percentage of non-optimally placed laser spots was 24.34% in group 1 and 7.99% in group 2. The uniformity of the placement was good in both groups (8.16 pixels and 8.44 pixels, respectively), no significant difference was reported (p=0.0591). Conclusion: pattern photocoagulation is preferable for DME compared to mono-impulse photocoagulation to provide adequate intensity of laser burns. Meanwhile, mono-impulse regimen provides more precise placement of laser spots. However, both conventional techniques are not effective enough due many intrinsic drawback, i.e., many laser spots are non-optimal in terms of intensity or placement. In routine practice, these drawbacks are outweighed by the skills and experience of laser surgeon. Planned precise placement of laser spots and the introduction of techniques of more precise preventive adjustment of energy level for each laser spot will contribute to the maximum effect of photocoagulation for DME. Further studies on personalized precise laser photocoagulation will improve the quality and efficacy of the treatment of macular edema. Keywords: diabetic retinopathy, diabetic macular edema, mono-impulse photocoagulation, pattern photocoagulation, navigated photocoagulation. For citation: Zamytskiy E.A., Zolotarev A.V., Karlova E.V. et al. Comparative quantitative assessment of the placement and intensity of laser spots for treating diabetic macular edema. Russian Journal of Clinical Ophthalmology. 2021;21(2):58–62. DOI: 10.32364/2311-7729- 2021-21-2-58-62.

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Section: актуальностьunclassified

Comparative quantitative assessment of the placement and intensity of laser spots for treating diabetic macular edema

Zamytskiy¹,

Золотарев²,

Карлова³

et al. 2021

Russian Journal of Clinical Ophthalmology

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Focal laser photocoagulation of the optic disc peripapillary neovascularization in patient with proliferative diabetic retinopathy

Takhchidi

Тахчиди

Касмынина

et al. 2022

MES

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Diabetic retinopathy (DR) is one of the most common complications of diabetes mellitus and one of the major causes of blindness in the developed world. Retinal laser photocoagulation is a gold standard for the treatment of DR. Despite its high efficiency, laser therapy has a number of limitations. The emergence of drugs, designed to inhibit the growth of the newly formed blood vessels, in ophthalmic practice made it possible to change treatment strategy in patients with retinal neovascularization. However, this method also has some adverse effects. Given the limitations on the repeated sessions of laser photocoagulation and the risks of ophtalmic complications after the intravitreal injection of the angiogenesis inhibitors, extraordinary situations, when there are negative results of treatment with the use of the described above techniques in one eye and disease progression in the single eye with preserved vision, become a serious problem when performing treatment. The clinical case reported has shown the feasibility of staged laser treatment in patient with the optic disc peripapillary neovascularization. Therapy has resulted in the regression of the newly formed blood vessels and visual function preservation.

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Anti-VEGF agents for the treatment of diabetic macular edema

Cited by 2 publications

References 0 publications

Comparative quantitative assessment of the placement and intensity of laser spots for treating diabetic macular edema

Comparative quantitative assessment of the placement and intensity of laser spots for treating diabetic macular edema

Focal laser photocoagulation of the optic disc peripapillary neovascularization in patient with proliferative diabetic retinopathy

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