Microperimetry and Fundus Autofluorescence in Diabetic Macular Edema

Lee

2014

Korean J Ophthalmol

PurposeThis pilot study aimed to evaluate the efficacy and safety of subthreshold micropulse yellow (577-nm) laser photocoagulation (SMYLP) in the treatment of diabetic macular edema (DME).MethodsWe reviewed 14 eyes of 12 patients with DME who underwent SMYLP with a 15% duty cycle at an energy level immediately below that of the test burn. The laser exposure time was 20 ms and the spot diameter was 100 µm. Laser pulses were administered in a confluent, repetitive manner with a 3 × 3 pattern mode.ResultsThe mean follow-up time was 7.9 ± 1.6 months. The baseline-corrected visual acuity was 0.51 ± 0.42 logarithm of the minimum angle of resolution (logMAR), which was improved to 0.40 ± 0.35 logMAR (p = 0.025) at the final follow-up. The central macular thickness at baseline was 385.0 ± 111.0 µm; this value changed to 327.0 ± 87.7 µm (p = 0.055) at the final follow-up.ConclusionsSMYLP showed short-term efficacy in the treatment of DME and did not result in retinal damage. However, prospective, comparative studies are needed to better evaluate the efficacy and safety of this treatment.

Section: Discussionmentioning

confidence: 99%

The Short-term Efficacy of Subthreshold Micropulse Yellow (577-nm) Laser Photocoagulation for Diabetic Macular Edema

Lee

2014

Korean J Ophthalmol

“…Conventional laser treatment can reduce contrast sensitivity and retinal sensitivity further by causing collateral neuroretinal damage. Subthreshold micropulse laser, might be the preferred choice of laser if laser is needed [6] as it can improve retinal sensitivity after the reabsorption of the edema. It is unclear whether anti-VEGF treated patients would behave differently.…”

Section: Discussionmentioning

confidence: 99%

Factors Affecting Reading Speed in Patients with Diabetic Macular Edema Treated with Laser Photocoagulation

2014

PurposeTo study the factors that may affect reading speed in patients with diabetic macular edema previously treated with laser photocoagulation.MethodsConsecutive patients with type II diabetes treated with laser photocoagulation for diabetic macular edema (DME) at least twelve months previously, with best corrected visual acuity of better than 65 letters (approximately 20/40) measured with Early Treatment Diabetic Retinopathy Study (ETDRS) charts were included in this study. Patients previously treated with pan-retinal photocoagulation, vitrectomy, intravitreal steroid or anti-VEGF therapy were excluded. Any other ocular co-morbidities that may influence reading ability such as cataract, glaucoma or macular degeneration were also excluded. All patients were refracted by a certified examiner, the following measurements were collected: best corrected visual acuity (BCVA), contrast sensitivity with Pelli-Robson chart, reading speed with MNREAD chart, microperimetry with Nidek MP1, and central subfield thickness with Zeiss spectral domain optical coherent topography.ResultsThe slow reading group had poorer contrast sensitivity (p = 0.001), reduced retinal sensitivity (p = 0.027) and less stable fixation (p = 0.013). Most interestingly the reduced retinal sensitivity findings were driven by the microperimetry value on the right subfield (p = 0.033), (nasal to the fovea in the right eye and temporal to the fovea in the left eye). Multiple linear regression analysis showed that contrast sensitivity is probably the most important factor that affects reading speed (p = 0.001).ConclusionReduced retinal sensitivity after laser treatment is associated with reduced reading speed in patients with diabetic macular edema.

BioMed Research International

“…Previous studies have used a variety of criteria to define lesion intensity, such as ophthalmoscopic invisibility [16], fluorescein angiographic (FLA) leakage [6, 11], optoacoustics [17], power titration according to reference lesions [18–20], long-term autofluorescence (AF) imaging [16], and others. We believe that modern optical coherence tomography (OCT) has the capacity to improve lesion definition significantly, as it represents a very sensitive method to detect and subclassify even lesions that remain ophthalmoscopically invisible [21, 22].…”

Section: Introductionmentioning

confidence: 99%

Comprehensive Detection, Grading, and Growth Behavior Evaluation of Subthreshold and Low Intensity Photocoagulation Lesions by Optical Coherence Tomographic and Infrared Image Analysis

Koinzer

Caliebe

Portz

et al. 2014

Purpose. To correlate the long-term clinical effect of photocoagulation lesions after 6 months, as measured by their retinal damage size, to exposure parameters. We used optical coherence tomographic (OCT)-based lesion classes in order to detect and assess clinically invisible and mild lesions. Methods. In this prospective study, 488 photocoagulation lesions were imaged in 20 patients. We varied irradiation diameters (100/300 µm), exposure-times (20–200 ms), and power. Intensities were classified in OCT images after one hour, and we evaluated OCT and infrared (IR) images over six months after exposure. Results. For six consecutive OCT-based lesion classes, the following parameters increased with the class: ophthalmoscopic, OCT and IR visibility rate, fundus and OCT diameter, and IR area, but not irradiation power. OCT diameters correlated with exposure-time, irradiation diameter, and OCT class. OCT classes discriminated the largest bandwidth of OCT diameters. Conclusion. OCT classes represent objective and valid endpoints of photocoagulation intensity even for “subthreshold” intensities. They are suitable to calculate the treated retinal area. As the area is critical for treatment efficacy, OCT classes are useful to define treatment intensity, calculate necessary lesion numbers, and universally categorize lesions in clinical studies.