scholarly journals Subthreshold Photocoagulation Using Endpoint Management in the PASCAL® System for Diffuse Diabetic Macular Edema

2018 ◽  
Vol 2018 ◽  
pp. 1-10 ◽  
Author(s):  
Masafumi Hamada ◽  
Kishiko Ohkoshi ◽  
Keiji Inagaki ◽  
Nobuyuki Ebihara ◽  
Akira Murakami
Keyword(s):  
Macular Edema ◽  
Diabetic Macular Edema ◽  
Fundus Autofluorescence ◽  
Autofluorescence Imaging ◽  
Grid Pattern ◽  
Threshold Size ◽  
Macular Volume ◽  
Macular Sensitivity ◽  
Primary Endpoints ◽  
Subthreshold Photocoagulation

We evaluated subthreshold photocoagulation using endpoint management (EPM) for the treatment of diabetic macular edema (DME). The study enrolled 10 eyes from 10 patients (6 men and 4 women) with DME. The entry criteria included central macular thickness (CMT) ≥ 300 μm and decimal visual acuity (VA) ≤ 0.5. The primary endpoints were VA (logMAR) and CMT at 6 months follow-up. Secondary endpoints included fundus autofluorescence, macular volume (MV), and macular sensitivity (MS). We used the PASCAL Streamline Yellow® (wavelength, 577 nm) system to perform grid pattern laser photocoagulation at 50% of the threshold (size, 100 μm; duration, 0.015 s; spacing, 0.5; and energy, 4.5–7.8 mJ). At 6 months posttreatment, CMT was significantly decreased, while there were no significant changes in macular sensitivity, mean BCVA (logMAR), or macular volume. Autofluorescence imaging revealed no changes after treatment in 6 of 10 eyes. No eyes exhibited subjective symptoms of scotoma after photocoagulation. Optical coherence tomography showed the complete resolution of macular edema in 4 eyes (40%) after a single treatment; MS was increased in all 4 of these eyes at 6 months posttreatment. In conclusion, subthreshold photocoagulation using EPM is safe and effective for DME treatment and preserves MS. This trial is registered with UMIN000012401.

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

2021 ◽  
Vol 13 ◽  
pp. 251584142097911
Author(s):  
Diego Alejandro Valera-Cornejo ◽  
Marlon García-Roa ◽  
Jaime Quiroz-Mendoza ◽  
Alejandro Arias-Gómez ◽  
Paulina Ramírez-Neria ◽  
...  
Keyword(s):  
Visual Acuity ◽  
Macular Edema ◽  
Diabetic Macular Edema ◽  
Macular Thickness ◽  
Thickness Change ◽  
Macular Volume ◽  
Naive Group ◽  
Micropulse Laser ◽  
Refractory Diabetic Macular Edema ◽  
Treatment Naïve

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.

Efficacy of Subthreshold Photocoagulation for Persistent Diabetic Macular Edema After Internal Limiting Membrane Peeling: A Retrospective Comparative Study

2021 ◽  
Author(s):  
Hirotsugu Takashina ◽  
Akira Watanabe ◽  
Koji Komatsu ◽  
Tadashi Nakano
Keyword(s):  
Macular Edema ◽  
Diabetic Macular Edema ◽  
Internal Limiting Membrane ◽  
Macular Thickness ◽  
Internal Limiting Membrane Peeling ◽  
Membrane Peeling ◽  
Group A ◽  
Group B ◽  
Subthreshold Photocoagulation ◽  
Persistent Diabetic Macular Edema

Abstract Background Subthreshold photocoagulation is one of the therapeutic options for treating diabetic macular edema, and have characteristic advantages, which are the lack of chorioretinal damage and the repeatability of the treatment. However, the effect of subthreshold photocoagulation is thought to be minimal among these options. In this study, we retrospectively examined the efficacy of repeated subthreshold photocoagulation for persistent diabetic macular edema after vitrectomy with peeling of the internal limiting membrane. Methods We enrolled ten consecutive eyes of eight patients who underwent monthly Endpoint Management™ (EpM) six times for diabetic macular edema that persisted for more than 3 months after vitrectomy with internal limiting membrane peeling for epiretinal membrane, and classified according to the interval between vitrectomy and initial EpM (Group A: within 6 months, Group B: beyond 6 months). Two type of retinal thickness (central macular thickness and macular thickness within 3mm diameter of the fovea) were measured monthly using optical coherence tomography. Results Mean intervals between vitrectomy and initial EpM were 4.0 ± 1.2 months (range 3–6 months) in Group A (six eyes of five patients) and 17.3 ± 7.5 months (range 10–27 months) in Group B (four eyes of four patients). No other treatments were performed between vitrectomy and initial EpM in Group A, while triamcinolone acetonide injection in the sub-Tenon’s capsule was performed in two eyes in Group B (one eye was injected thrice, the other eye received a single injection). Improvement rates of mean central macular thickness after 6 months were 18.2% in all eyes, 10.8% in Group A, and 28.7% in Group B, and improvement rates of mean macular thickness within 3mm diameter of the fovea after 6 months were 8.5% in all eyes, 4.1% in Group A, and 15.3% in Group B. Conclusions Monthly EpM treatment was efficacious against persistent diabetic macular edema after internal limiting membrane peeling. In particular, the efficacy was greater in eyes in which the initial EpM was performed more than 6 months after vitrectomy. Furthermore, residual efficacy of triamcinolone acetonide, which was injected at the end of vitrectomy, might have contributed to the results.

The Relationship Between Macular Sensitivity and Retinal Thickness in Eyes With Diabetic Macular Edema

2011 ◽  
Vol 152 (3) ◽  
pp. 400-405.e2 ◽  
Author(s):  
Elham Hatef ◽  
Elizabeth Colantuoni ◽  
Jianmin Wang ◽  
Mohamed Ibrahim ◽  
Matthew Shulman ◽  
...  
Keyword(s):  
Macular Edema ◽  
Diabetic Macular Edema ◽  
Retinal Thickness ◽  
Macular Sensitivity ◽  
The Relationship

scholarly journals Classification of fundus autofluorescence abnormal patterns in diabetic macular edema

2020 ◽  
Vol 155 (5) ◽  
Author(s):  
Sergio Hernández-Da Mota ◽  
Virgilio Lima-Gómez ◽  
Ernesto Rodríguez-Ayala ◽  
Jorge Jans Fromow-Guerra ◽  
Enrique Alfonso Roig Melo-Granados
Keyword(s):  
Macular Edema ◽  
Diabetic Macular Edema ◽  
Fundus Autofluorescence

scholarly journals Association of Fundus Autofluorescence Findings and Outer Retinal Lesions on Optical Coherence Tomography With Visual Acuity in Birdshot Chorioretinopathy

2019 ◽  
Vol 3 (4) ◽  
pp. 235-241
Author(s):  
Laura J. Kopplin ◽  
Marion Munk ◽  
Justin Baynham ◽  
James T. Rosenbaum ◽  
Eric B. Suhler ◽  
...  
Keyword(s):  
Optical Coherence Tomography ◽  
Visual Acuity ◽  
Macular Edema ◽  
Vision Loss ◽  
Fundus Autofluorescence ◽  
Demographic Data ◽  
Optical Coherence ◽  
Autofluorescence Imaging ◽  
Birdshot Chorioretinopathy ◽  
Retinal Lesions

Purpose: This article investigates the optical coherence tomography (OCT) and fundus autofluorescence imaging findings in birdshot chorioretinopathy (BSCR) and their association with visual acuity (VA). Methods: In a retrospective, cross-sectional study, we evaluated OCT images for changes in retinal structure including cystoid macular edema (CME), epiretinal membrane, and outer retinal lesions. We assessed autofluorescence images for hypoautofluorescent and hyperautofluorescent changes and noted the distribution of the lesions. Demographic data and VA at the time of imaging were also collected. Associations between OCT and autofluorescence findings and logarithm of the minimum angle of resolution VA were tested using linear regression. Results: We conducted a chart review of 80 eyes from 40 patients with BSCR. Outer retinal lesions were found on OCT in 28 of 80 eyes (35%) and disruption of the outer segment ellipsoid zone (EZ) occurred in 23 eyes (28.7%). Macular hypoautofluorescent lesions were more common than hyperautofluorescent lesions, present in 58.8% and 13% of eyes, respectively. The presence of outer retinal lesions on OCT was significantly associated with reduced VA ( P = .006) as was EZ disruption ( P = .003). These associations remained significant after accounting for the presence of macular edema. There was a trend toward association of macular hypoautofluorescent lesions with decreased vision, although it was not statistically significant ( P = .17). Conclusions: The association of outer retinal lesions with decreased VA suggests a mechanism of central vision loss that is distinct from CME and may provide an additional objective finding to monitor disease activity in BSCR patients.

scholarly journals Bromfenac Eyedrops in the Treatment of Diabetic Macular Edema: A Pilot Study

2016 ◽  
Vol 27 (3) ◽  
pp. 326-330 ◽  
Author(s):  
Antonio Pinna ◽  
Francesco Blasetti ◽  
Giuseppe D'Amico Ricci ◽  
Francesco Boscia
Keyword(s):  
Pilot Study ◽  
Macular Edema ◽  
Diabetic Macular Edema ◽  
Statistical Significance ◽  
Newly Diagnosed ◽  
Multicenter Studies ◽  
Primary Endpoints ◽  
Systemic Side Effects ◽  
Term Benefit

Purpose To evaluate the efficacy and safety of topical bromfenac in patients with newly diagnosed diabetic macular edema (DME). Methods In this pilot study including 17 patients with monocular, newly diagnosed DME, diagnosis of DME was established by the detection of retinal thickening at or within 500 μm of the center of the macula on ophthalmoscopic examination, according to the Early Treatment Diabetic Retinopathy Study classification. Central macular thickness (CMT) was determined by optical coherence tomography. Bromfenac sodium hydrate 0.9 mg/mL eyedrops were administered in the affected eye twice daily for 30 days. Primary endpoints were changes in best-corrected visual acuity (BCVA) and CMT at the end of therapy. Results Topical bromfenac significantly reduced mean CMT, from 465.41 ± 118.47 μm at baseline to 388.88 ± 152.63 μm posttreatment (p = 0.02). There was no significant change in BCVA and differences in mean macular volume fell just short of statistical significance (p = 0.06). Treatment was well-tolerated, and there were no topical or systemic side effects. Conclusions Topical bromfenac twice daily may play a role in the reduction of DME. These preliminary results warrant further larger multicenter studies to confirm our findings and establish whether topical bromfenac may be of long-term benefit in the treatment of DME.

scholarly journals Efıcacy of Mıcropulse Laser In The Treatment of Dıabetıc Macular Edema

2021 ◽  
Author(s):  
Faruk Bıçak ◽  
Özcan Rasim Kayıkçıoğu ◽  
Muhammed Altınışık ◽  
Suzan Doğruya ◽  
Emin Kurt
Keyword(s):  
Visual Acuity ◽  
Macular Edema ◽  
Diabetic Macular Edema ◽  
Macular Thickness ◽  
Central Macular Thickness ◽  
Intravitreal Ranibizumab ◽  
Thickness Change ◽  
Macular Volume ◽  
Micropulse Laser ◽  
Significant Difference

Abstract Purpose: In this study, we aimed to evaluate and compare the visual acuity, macular volume, central macular thickness, change in number of intravitreal ranibizumab injections with micropulse laser applications after loading dose of antiVEGF to DME patients.Study Design: Retrospective study Methods: This study was carried out on 97 patients (45 ranibizumab and 52 micropuls grid laser + ranibizumab) with diabetic macular edema patients who were followed in the Retina Unit. At the control visit after three loading ranibizumab injections administered once a month, micropuls grid laser was applied to one group and ranibizumab injection was continued PRN to both groups for an average of 9.27 ± 2.42 months and central macular thickness, macular volume and visual acuity were recorded. Results: There was no significant difference between the groups in terms of gender, smoking and systemic diseases, initial central macular thickness, macular volume and visual acuity measurements (p> 0.05). Central macular thickness, macular volume and visual acuity values measured at the last follow-up of the patients were not significantly different between the groups (p> 0.05). The mean post-treatment injection requirement was 4.19 ± 1.01 for the ranibizumab with micropuls laser group and 5.53 ± 1.14 for the ranibizumab group. In the group treated with micropuls laser, statistically less number of intravitreal ranibizumab injections were needed (p <0.001). Conclusion: Micropulse laser treatment after initial loading doses reduces the need for antiVEGF injections. Studies with the participation of more patients may help in the selection of treatment methods by comparing micropulse laser combined with different injection protocols.

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