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Long-term therapeutic efficacy of the subthreshold micropulse diode laser photocoagulation for diabetic macular edema

  • Clinical Investigation
  • Published:
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Abstract

Purpose

To investigate the long-term efficacy of subthreshold micropulse diode laser photocoagulation (SMDLP) on diabetic macular edema (DME).

Methods

The effects of SMDLP (810 nm) were studied on 56 eyes of 44 patients with DME. Optical coherence tomography-determined foveal thickness and best-corrected visual acuity (BCVA) were evaluated at 1, 3, 6, and 12 months after the SMDLP.

Results

The mean foveal thickness was 504 μm before the SMDLP, and it was significantly reduced to 439 μm at 1 month (P = 0.001), 409 μm at 3 months (P < 0.0001), 358 μm at 6 months (P < 0.0001), and 320 μm at 12 months (P < 0.0001). The mean BCVA at baseline was 0.47 logarithm of the minimal angle of resolution (logMAR) units, and it was not changed significantly at all of the postoperative examinations. Among the 56 eyes, 10 (17.8%) had an improvement of BCVA of >0.2 logMAR units, 36 (64.2%) remained the same, and 10 eyes (17.8%) had a reduction of >0.2 logMAR units at 12 months postoperatively.

Conclusion

Our results indicate that SMDLP has a beneficial effect on DME. However, prospective studies are needed to evaluate this technique in more detail.

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References

  1. Early Treatment Diabetic Retinopathy Study Research Group. Photocoagulation for diabetic macular edema. Early Treatment Diabetic Retinopathy Study Report Number 1. Arch Ophthalmol. 1985;103:1796–806.

    Article  Google Scholar 

  2. Maeshima K, Utsugi-Sutoh N, Otani T, Kishi S. Progressive enlargement of scattered photocoagulation scars in diabetic retinopathy. Retina. 2004;24:507–11.

    Article  PubMed  Google Scholar 

  3. Fong DS, Segal PP, Myers F, Ferris FL, Hubbard LD, Davis MD. Subretinal fibrosis in diabetic macular edema. Early Treatment Diabetic Retinopathy Study Research Group. ETDRS report 23. Arch Ophthalmol. 1997;115:873–7.

    Article  CAS  PubMed  Google Scholar 

  4. Lewis H, Abrams GW, Blumenkranz MS, Campo RV. Vitrectomy for diabetic macular traction and edema associated with posterior hyaloidal traction. Ophthalmology. 1992;99:753–9.

    Article  CAS  PubMed  Google Scholar 

  5. Gandorfer A, Messmer EM, Ulbig MW, Kampik A. Resolution of diabetic macular edema after surgical removal of the posterior hyaloids and inner limiting membrane. Retina. 2000;20:126–33.

    Article  CAS  PubMed  Google Scholar 

  6. Pendergast SD, Hassan TS, Williams GA, Cox MS, Margherio RR, Ferrone PJ, et al. Vitrectomy for diffuse diabetic macular edema associated with a taut premacular posterior hyaloid. Am J Ophthalmol. 2000;130:178–86.

    Article  CAS  PubMed  Google Scholar 

  7. Tachi N, Ogino N. Vitrectomy for diffuse macular edema in case of diabetic retinopathy. Am J Ophthalmol. 1996;122:258–60.

    Article  CAS  PubMed  Google Scholar 

  8. Yamamoto T, Hitani K, Tsukahara I, Yamamoto S, Kawasaki R, Yamashita H, et al. Early postoperative retinal thickness changes and complications after vitrectomy for diabetic macular edema. Am J Ophthalmol. 2003;135:14–9.

    Article  PubMed  Google Scholar 

  9. Otani T, Kishi S. A controlled study of vitrectomy for diabetic macular edema. Am J Ophthalmol. 2002;134:214–9.

    Article  PubMed  Google Scholar 

  10. Jonas JB, Kreissig I, Söfeker A, Degenring RF. Intravitreal injection of triamcinolone for diffuse diabetic macular edema. Arch Ophthalmol. 2003;121:57–61.

    Article  CAS  PubMed  Google Scholar 

  11. Diabetic Retinopathy Clinical Research Network. A phase randomized clinical trial of intravitreal bevacizumab for diabetic macular edema. Ophthalmology. 2007;114:1860–7.

    Article  PubMed Central  Google Scholar 

  12. Diabetic Retinopathy Clinical Research Network. A randomized trial comparing intravitreal triamucinolone acetonide and focal/grid photocoagulation for diabetic macular edema. Ophthalmology. 2008;115:1447–59.

    Article  PubMed Central  Google Scholar 

  13. Pankratov MM. Pulsed delivery of laser energy in experimental thermal retinal photocoagulation. Proc Soc Photo Opt Instrum Eng. 1990;1202:205–13.

    Google Scholar 

  14. Sliney DH, Marshall J. Tissue specific damage to the retinal pigment epithelium:mecanisms and therapeutic implications. Lasers Light Ophthalmol. 1992;5:17–28.

    Google Scholar 

  15. Friberg TR, Karatza EC. The treatment of macular disease using a micropulsed and continuous wave 810-nm diode laser. Ophthalmology. 1997;104:2030–8.

    Article  CAS  PubMed  Google Scholar 

  16. Moorman CM, Hamilton AMP. Clinical applications of the micropulse diode laser. Eye. 1999;13:145–50.

    Article  PubMed  Google Scholar 

  17. Luttrull JK, Musch DC, Mainster MA. Subthreshold diode micropulse photocoagulationa for the treatment of clinically significant diabetic macular oedema. Br J Ophthalmol. 2005;89:74–80.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  18. Laursen ML, Moeller F, Sander B, Sjoelie AK. Subthreshold micropulse diode laser treatment in diabetic macular oedema. Br J ophthalmol. 2004;88:1173–9.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  19. Luttrull JK, Spink CJ. Serial optical coherence tomography of subthreshold diode laser micropulse photocoagulation for diabetic macular edema. Ophathalmic Surg Lasers Imaging. 2006;37:370–7.

    Google Scholar 

  20. Ohkoshi K, Yamaguchi T. Subthreshold micropulse diode laser photocoagulation for diabetic macular edema in Japanese patients. Am J Ophthalmol. 2010;149:133–9.

    Article  PubMed  Google Scholar 

  21. Steffánsson E. The therapeutic effects of retinal treatment and vitrectomy. A theory based on oxygen and vascular physiology. Acta Ophthalmol Scand. 2001;79:435–40.

    Article  Google Scholar 

  22. Pollack JS, Kim JE, Pulido JS, Burker JM. Tissue effects of subclinical diode laser treatment of the retina. Arch Ophthalmol. 1998;116:1633–9.

    Article  CAS  PubMed  Google Scholar 

  23. Roider J, Norman AM, Flotte TJ, Birngruber R. Response of the retinal pigment epithelium to selective photocoagulation. Arch Ophthalmol. 1992;110:1786–92.

    Article  CAS  PubMed  Google Scholar 

  24. Figueira J, Khan J, Nunes S, Sivaprasad S, Rosa A, de Abreu JF, et al. Prospective randomized controlled trial comparing sub-threshold micropulse diode laser photocoagulation and conventional green laser for clinically significant diabetic macular oedema. Br J Ophthalmol. 2009;93:1341–4.

    Article  CAS  PubMed  Google Scholar 

  25. Vujosevic S, Bottega E, Casciano M, Pilotto E, Convento E, Midena E. Microperimetry and fundus autofluorescence in diabetic macular edema. Subthreshold micropulse diode laser versus modified Early Treatment Diabetic Retinopathy Study laser photocoagulation. Retina. 2010;X:1–9.

    Google Scholar 

Download references

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Correspondence to Yoko Takatsuna.

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Takatsuna, Y., Yamamoto, S., Nakamura, Y. et al. Long-term therapeutic efficacy of the subthreshold micropulse diode laser photocoagulation for diabetic macular edema. Jpn J Ophthalmol 55, 365–369 (2011). https://doi.org/10.1007/s10384-011-0033-3

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  • DOI: https://doi.org/10.1007/s10384-011-0033-3

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