Article Text

Download PDFPDF

“Light” versus “classic” laser treatment for clinically significant diabetic macular oedema
Free
  1. F Bandello1,
  2. A Polito1,
  3. M Del Borrello1,
  4. N Zemella1,
  5. M Isola2
  1. 1Department of Ophthalmology, University of Udine, Udine, Italy
  2. 2Department of Medical and Morphological Research, University of Udine, Udine, Italy
  1. Correspondence to: Francesco Bandello MD, Department of Ophthalmology, University of Udine, P le S Maria della Misericordia, 33100 Udine, Italy; francesco.bandellouniud.it

Abstract

Aim: To compare the effectiveness of “light” versus “classic” laser photocoagulation in diabetic patients with clinically significant macular oedema (CSMO).

Methods: A prospective randomised pilot clinical trial in which 29 eyes of 24 diabetic patients with mild to moderate non-proliferative diabetic retinopathy (NPDR) and CSMO were randomised to either “classic” or “light” Nd:YAG 532 nm (frequency doubled) green laser. “Light” laser treatment differed from conventional (“classic”) photocoagulation in that the energy employed was the lowest capable to produce barely visible burns at the level of the retinal pigment epithelium. Primary outcome measure was the change in foveal retinal thickness as measured by optical coherence tomography (OCT); secondary outcomes were the reduction/elimination of macular oedema on contact lens biomicroscopy and fluorescein angiography, change in visual acuity, contrast sensitivity, and mean deviation in the central 10° visual field. Examiners were masked to patients’ treatment.

Results: 14 eyes were assigned to “classic” and 15 were assigned to “light” laser treatment. At 12 months, seven (50%) of 14 eyes treated with “classic” and six (43%) of 14 eyes treated with “light” laser had a decrease of foveal retinal thickness on OCT (p = 0.79). A comparison of reduction/elimination of oedema, visual improvement, visual loss, change in contrast sensitivity, and mean deviation in the central 10° showed no statistical difference between the groups at 12 months (p>0.05 for all groups).

Conclusions: This study suggests that “light” photocoagulation for CSMO may be as effective as “classic” laser treatment, thus supporting the rationale for a larger equivalence trial.

  • CSMO, clinically significant macular oedema
  • ETDRS, Early Treatment Diabetic Retinopathy Study
  • FA, fluorescein angiography
  • FTH, foveal thickness
  • MD, mean deviation
  • NPDR, non-proliferative diabetic retinopathy
  • OCT, optical coherence tomography
  • PEDF, pigment epithelium derived factor
  • RPE, retinal pigment epithelium
  • VA, visual acuity
  • clinically significant macular oedema
  • laser treatment
  • CSMO, clinically significant macular oedema
  • ETDRS, Early Treatment Diabetic Retinopathy Study
  • FA, fluorescein angiography
  • FTH, foveal thickness
  • MD, mean deviation
  • NPDR, non-proliferative diabetic retinopathy
  • OCT, optical coherence tomography
  • PEDF, pigment epithelium derived factor
  • RPE, retinal pigment epithelium
  • VA, visual acuity
  • clinically significant macular oedema
  • laser treatment

Statistics from Altmetric.com

Footnotes

Request Permissions

If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.

Linked Articles

  • BJO at a glance
    Creig Hoyt