"Light" versus "classic" laser treatment for clinically significant diabetic macular oedema

Bandello, Francesco

doi:10.1136/bjo.2004.051060

Cited by 68 publications

(35 citation statements)

References 26 publications

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“…Despite a small lesion size, filling-in was not complete, and central defects were still seen in 50% of lesions. 43 In terms of an optimal therapeutic benefit without side effects light PRP, subvisible treatment 44 and micropulse modalities 45 are suggested.…”

Section: Discussionmentioning

confidence: 99%

Retinal Architecture Recovery After Grid Photocoagulation in Diabetic Macular Edema Observed in Vivo by Spectral Domain Optical Coherence Tomography

Mylonas

Bolz

Kriechbaum

et al. 2013

Retina

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Section: Discussionmentioning

confidence: 99%

Retinal Architecture Recovery After Grid Photocoagulation in Diabetic Macular Edema Observed in Vivo by Spectral Domain Optical Coherence Tomography

Mylonas

Bolz

Kriechbaum

et al. 2013

Retina

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“…Other studies have found similar results; however, the strengths of correlation have varied widely (Table 3). [7][8][10][11][12][13][14][15][16] Some of these studies have used the central subfield mean thickness instead of center point thickness. However, since correlation of the two measures is 0.98, results of these studies can be compared.…”

Section: Discussionmentioning

confidence: 99%

“…7-9 Previous studies have reported different degrees of correlation between OCT-measured retinal thickness and visual acuity ranging from 0.28 to 0.73. [7][8][10][11][12][13][14][15][16] If the correlation between OCT-measured macular thickness and vision were particularly strong, one might be able to consider the OCT measurement as a surrogate measure of visual function in clinical trials of DME. A surrogate outcome in a clinical trial is used because it predates or predicts the actual measure of interest.…”

Section: Introductionmentioning

confidence: 99%

Relationship between Optical Coherence Tomography–Measured Central Retinal Thickness and Visual Acuity in Diabetic Macular Edema

2007

Ophthalmology

489

149

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Objective-To compare optical coherence tomography (OCT)-measured retinal thickness and visual acuity in eyes with diabetic macular edema (DME) both before and after macular laser photocoagulation.Design-Cross-sectional and longitudinal study.Participants-210 subjects (251 eyes) with DME enrolled in a randomized clinical trial of laser techniques.Methods-Retinal thickness was measured with OCT and visual acuity was measured with the electronic-ETDRS procedure. Main Outcome Measures-OCT-measured center point thickness and visual acuityResults-The correlation coefficients for visual acuity versus OCT center point thickness were 0.52 at baseline and 0.49, 0.36, and 0.38 at 3.5, 8, and 12 months post-laser photocoagulation. The slope of the best fit line to the baseline data was approximately 4.4 letters (95% C.I.: 3.5, 5.3) better visual acuity for every 100 microns decrease in center point thickness at baseline with no important difference at follow-up visits. Approximately one-third of the variation in visual acuity could be predicted by a linear regression model that incorporated OCT center point thickness, age, hemoglobin A1C, and severity of fluorescein leakage in the center and inner subfields. The correlation between change in visual acuity and change in OCT center point thickening 3.5 months after laser treatment was 0.44 with no important difference at the other follow-up times. A subset of eyes showed paradoxical improvements in visual acuity with increased center point thickening (7-17% at the three time points) or paradoxical worsening of visual acuity with a decrease in center point thickening (18%-26% at the three time points).Conclusions-There is modest correlation between OCT-measured center point thickness and visual acuity, and modest correlation of changes in retinal thickening and visual acuity following focal laser treatment for DME. However, a wide range of visual acuity may be observed for a given degree of retinal edema and paradoxical increases in center point thickening with increases in visual acuity as well as paradoxical decreases in center point thickening with decreases in visual acuity were not uncommon. Thus, although OCT measurements of retinal thickness represent an important

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“…Previous studies, which have compared subthreshold micropulse diode photocoagulation with conventional green laser, 17 and 'light' and 'classic' Nd:YAG (frequency doubled) laser, 20 showed comparable clinical results between the two modalities. Subthreshold diode laser and conventional threshold diode laser have not been compared in terms of effect on CS or PSRT.…”

Section: Discussionmentioning

confidence: 99%

Functional outcome of subthreshold versus threshold diode laser photocoagulation in diabetic macular oedema

Kumar

Ghosh

Mehta

et al. 2010

Eye

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Aims: To compare the efficacy of subthreshold diode laser photocoagulation with conventional threshold diode laser in clinically significant macular oedema (CSME) in diabetics. Methods: Prospective randomised controlled trial. Thirty eyes of 20 patients with CSME having central macular thickness (CMT) X250 lm on optical coherence tomography (OCT) and best corrected Snellen visual acuity (BCVA) of 20/80 or better were randomly assigned to receive subthreshold diode laser (group A) or threshold laser (group B). The clinical course of BCVA, CMT on OCT, photo stress recovery time (PSRT), contrast sensitivity (CS) using Pelli Robson chart, and central visual field (10-2 VF, Humphrey Field Analyser II) were monitored regularly for 18 weeks after intervention. Results: Both groups showed significant (P ¼ 0.03) and comparable improvement in mean BCVA at 18 weeks visit. There were also significant and comparable reductions (Po0.01) in mean CMT at all visits compared with baseline in both groups. PSRT and CS (75±16 (mean±SD) and 0.72±0.3 in group A and 81±12 and 0.68±0.2 in group B pre-laser) were significantly better in group A at the final visit (66±17 and 1.04±0.3) as compared to group B (78 ± 11 and 0.73 ± 0.3). One patient in group B showed a paracentral scotoma on 10-2 VF after the laser, which persisted till the end of follow-up. Conclusion: Subthreshold diode laser photocoagulation is as effective as conventional threshold laser in reducing or eliminating diabetic macular oedema (on OCT) and in improving BCVA. Recovery of macular function as assessed by CS and PSRT maybe better with subthreshold laser.

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"Light" versus "classic" laser treatment for clinically significant diabetic macular oedema

Cited by 68 publications

References 26 publications

Retinal Architecture Recovery After Grid Photocoagulation in Diabetic Macular Edema Observed in Vivo by Spectral Domain Optical Coherence Tomography

Retinal Architecture Recovery After Grid Photocoagulation in Diabetic Macular Edema Observed in Vivo by Spectral Domain Optical Coherence Tomography

Relationship between Optical Coherence Tomography–Measured Central Retinal Thickness and Visual Acuity in Diabetic Macular Edema

Functional outcome of subthreshold versus threshold diode laser photocoagulation in diabetic macular oedema

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