Effects of subthreshold diode micropulse laser photocoagulation on treating patients with refractory diabetic macular edema

Akhlaghi, Mohammadreza; Dehghani, Alireza; Pourmohammadi, Reza; Asadpour, Leila; Pourazizi, Mohsen

doi:10.1016/j.joco.2018.11.006

Cited by 21 publications

(24 citation statements)

References 25 publications

(24 reference statements)

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Another noteworthy result is that, over the course of the follow-up period, no patients required intravitreal therapy. This confirms the previously reported potential for SMPL to control intraretinal fluid and alleviate the burden of intravitreal treatments [ 4 , 34 , 35 ]; SMPL was effective in keeping retinal thickness under control, stabilizing macular retinal homeostasis. A recent study has shown that visual acuity (in term of loss of five or more ETDRS letters) is not significantly different among eyes initially managed with intravitreal aflibercept, laser photocoagulation or observation at 2 years’ follow-up, in patients with good visual acuity (>79 ETDRS score) at baseline [ 36 ].…”

Section: Discussionsupporting

confidence: 90%

Diabetic Macular Edema Treated with 577-nm Subthreshold Micropulse Laser: A Real-Life, Long-Term Study

Frizziero

Calciati

Torresin

et al. 2021

JPM

View full text Add to dashboard Cite

The aim of this study was to evaluate the long-term efficacy and safety of 577-nm subthreshold micropulse laser (SMPL) treatment in a large population of patients affected by mild diabetic macular edema (DME) in a real-life setting. We retrospectively evaluated 134 eyes affected by previously untreated center-involving mild DME, and treated with 577-nm SMPL, using fixed parameters. Retreatment was performed at 3 months, in case of persistent retinal thickening. Optical coherence tomography (OCT), along with short and near-infrared fundus autofluorescence, were used to confirm long-term safety. At the end of at least one year follow-up, a significant improvement in visual acuity was documented, compared to baseline (77.3 ± 4.5 and 79.4 ± 4.4 ETDRS score at baseline and at final follow-up, respectively), as well as a reduction in the mean retinal thickness of the thickest ETDRS macular sector at baseline. A reduction in the central retinal thickness and the mean thickness of the nine ETDRS sectors was also found, without reaching statistical significance. No patients required intravitreal injections. No adverse effects were detected. This study suggests that 577-nm SMPL is a safe and repeatable treatment for mild DME that may be applied to real-life clinical settings using fixed parameters and protocols.

show abstract

Section: Discussionsupporting

confidence: 90%

Diabetic Macular Edema Treated with 577-nm Subthreshold Micropulse Laser: A Real-Life, Long-Term Study

Frizziero

Calciati

Torresin

et al. 2021

JPM

View full text Add to dashboard Cite

show abstract

“…Our study did not demonstrate any clinically significant difference (despite the statistical difference in the treatment-naïve group at 12 weeks) in CMT (mean ± SD: −30 ± 125 and −12 ± 128 µm in the treatment-naïve and refractory groups, respectively; p = 0.011 and p = 0.34), thickness area, and macular volume at 3 months and between the groups, which is very similar to many studies. 22,24,29–35,37–39 Although, by now, we know that an anatomical reduction of macular edema is not always followed by an improvement in visual acuity, the relationship between these two variables is weak. 40 On the contrary, few reports showed a more important visual and anatomic response, 25,29 but some of them did not use micropulse laser as a monotherapy.…”

Section: Discussionmentioning

confidence: 99%

“…40 On the contrary, few reports showed a more important visual and anatomic response, 25,29 but some of them did not use micropulse laser as a monotherapy. 36,41…”

Section: Discussionmentioning

confidence: 99%

Micropulse laser in patients with refractory and treatment-naïve center–involved diabetic macular edema: short terms visual and anatomic outcomes

et al. 2021

View full text Add to dashboard Cite

Purpose: The purpose of the study is to describe visual and anatomic outcomes of 5774nm micropulse laser photocoagulation in eyes with either treatment-naïve or refractory diabetic macular edema (DME) at 3 months. Methods: This was a prospective case series that recruited 23 consecutive patients (33 eyes) with center-involved DME that was either treatment-naïve or had not responded to prior treatment. Micropulse therapy was performed with the Easy Ret 577 (Quantel Medical, Cournon d’Auvergne, France) diode laser in a high-density manner in eyes with treatment-naïve or refractory DME. The primary outcome was the change of best-corrected visual acuity (BCVA; logMAR) at 1 and 3 months. Secondary outcomes were changes in the central macular thickness (CMT), thickness area, macular volume, and macular capillary leakage at 1 and 3 months. Results: There were no significant changes in BCVA at 3 months, with mean ± standard deviation (SD) of −0.08 ± 0.01 ( p = 0.228) and + 0.01 ± 0.01 ( p = 0.969) for treatment-naïve and refractory groups, respectively. The change in CMT at 3 months was statistically but not clinically significant in the treatment-naïve group only (mean ± SD; –30 ± 130 µm; p = 0.011). The macular volume and area thickness change were not statistically significant ( p = 0.173 and p = 0.148 for macular volume and area thickness, respectively) in the treatment-naïve group. There was no difference concerning the leakage area in both groups. No adverse events were reported. Conclusion: We concluded that micropulse 577nm laser therapy maintained the visual acuity and macular thickness at 3 months in both treatment-naïve and refractory DME.

show abstract

“…In the only study evaluating micropulse laser in anti-VEGF-resistant DME, 21 patients had one eye randomly assigned to micropulse laser with intravitreal anti-VEGF and the other eye treated with anti-VEGF monotherapy. At three months, visual acuity decreased significantly in the anti-VEGF monotherapy group (20/100 to 20/123) and increased significantly in the combination group (20/129 to 20/83) [ 143 ]. This therapy is a relatively recent advancement; hence, there is only limited research and long-term outcomes are unclear.…”

Section: Diabetic Retinopathy and Diabetic Macular Edemamentioning

confidence: 99%

Anti-VEGF-Resistant Retinal Diseases: A Review of the Latest Treatment Options

Wallsh

Gallemore

2021

Cells

View full text Add to dashboard Cite

Anti-vascular endothelial growth factor (anti-VEGF) therapy currently plays a central role in the treatment of numerous retinal diseases, most notably exudative age-related macular degeneration (eAMD), diabetic retinopathy and retinal vein occlusions. While offering significant functional and anatomic benefits in most patients, there exists a subset of 15–40% of eyes that fail to respond or only partially respond. For these cases, various treatment options have been explored with a range of outcomes. These options include steroid injections, laser treatment (both thermal therapy for retinal vascular diseases and photodynamic therapy for eAMD), abbreviated anti-VEGF treatment intervals, switching anti-VEGF agents and topical medications. In this article, we review the effectiveness of these treatment options along with a discussion of the current research into future directions for anti-VEGF-resistant eyes.

show abstract

Effects of subthreshold diode micropulse laser photocoagulation on treating patients with refractory diabetic macular edema

Cited by 21 publications

References 25 publications

Diabetic Macular Edema Treated with 577-nm Subthreshold Micropulse Laser: A Real-Life, Long-Term Study

Diabetic Macular Edema Treated with 577-nm Subthreshold Micropulse Laser: A Real-Life, Long-Term Study

Micropulse laser in patients with refractory and treatment-naïve center–involved diabetic macular edema: short terms visual and anatomic outcomes

Anti-VEGF-Resistant Retinal Diseases: A Review of the Latest Treatment Options

Contact Info

Product

Resources

About