scholarly journals The use of diod laser in microphotocoagulation and high density photocoagulation regimens in the treatment of diabetic macular edema

2016 ◽  
Vol 9 (2) ◽  
pp. 27-29
Author(s):  
Aleksandr S Izmaylov ◽  
Tat’yana V Kotsur
Keyword(s):  
Diabetic Retinopathy ◽  
Macular Edema ◽  
Diabetic Macular Edema ◽  
Laser Photocoagulation ◽  
Retinal Pigment ◽  
High Density ◽  
Retinal Sensitivity ◽  
Laser Applications ◽  
Clinically Significant ◽  
Modern Standard

The modern standard of treatment of clinically significant diabetic macular edema is macular laser photocoagulation was suggested in the reports of the Early Treatment of Diabetic Retinopathy Study (ETDRS, 1985-1990). Subthreshold microphotocoagulation (MicroPulase) leads to developing barely visible or invisible retinal burns and also has been shown to be effective in treating macular edema with no side effects comparing with ETDRS methodic (retinal pigment and choroidal atrophy, decreasing of retinal sensitivity). Effectiveness of microphotocoagulation may arise in high density laser applications, however in modern literature exists rare publications concerning this question.

scholarly journals COMPARATIVE ESTIMATION OF LASER COAGULATION EFFICIENCY IN MACULAR AND MICROPHOTOCOAGULATION OF HIGH DENSITYIN DIABETIC MACULOPATHY TREATMENT

2015 ◽  
Vol 7 (1) ◽  
pp. 74-77
Author(s):  
A S Izmaylov ◽  
T V Kotsur
Keyword(s):  
Diabetic Retinopathy ◽  
Macular Edema ◽  
Laser Photocoagulation ◽  
Retinal Pigment ◽  
Laser Coagulation ◽  
Retinal Sensitivity ◽  
Diabetic Maculopathy ◽  
Laser Applications ◽  
Clinically Significant ◽  
Modern Standard

The modern standard of treatment of clinically significant diabetic macular edema is macular laser photocoagulation was suggested in the reports of the Early Treatment of Diabetic Retinopathy Study (ETDRS, 1985-1990). Subthreshold microphotocoagulation (MicroPulase) leads to developing barely visible or invisible retinal burns and also has been shown to be effective in treating macular edema with no side effects comparing with ETDRS methodic (retinal pigment and choroidal atrophy, decreasing of retinal sensitivity). Effectiveness of microphotocoagulation may arise in high density laser applications, however in modern literature exists rare publications concerning this question.

Photocoagulation for Diabetic Macular Edema

2020 ◽  
pp. 169-176
Author(s):  
Alan D. Penman ◽  
Kimberly W. Crowder ◽  
William M. Watkins
Keyword(s):  
Diabetic Retinopathy ◽  
Macular Edema ◽  
Diabetic Macular Edema ◽  
Laser Photocoagulation ◽  
Argon Laser ◽  
Diabetic Patients ◽  
Nonproliferative Diabetic Retinopathy ◽  
Argon Laser Photocoagulation ◽  
Clinically Significant Macular Edema ◽  
Clinically Significant

The Early Treatment Diabetic Retinopathy Study (ETDRS) was a randomized clinical trial involving nearly four thousand diabetic patients with early proliferative retinopathy, moderate to severe nonproliferative retinopathy, and/or diabetic macular edema in each eye. This paper (ETDRS report number 1) describes the findings in the subgroup of eyes in the ETDRS that were identified as having mild to moderate nonproliferative diabetic retinopathy and macular edema. The analysis showed that immediate focal argon laser photocoagulation of “clinically significant” diabetic macular edema substantially reduced the risk of visual loss, increased the chance of visual improvement, decreased the frequency of persistent macular edema, and caused only minor visual field losses. The authors recommended immediate focal argon laser photocoagulation for all eyes with clinically significant macular edema and mild or moderate nonproliferative diabetic retinopathy, regardless of the level of visual acuity.

VISUAL OUTCOME IN DIABETIC MACULAR EDEMA AFTER GRID LASER TREATMENT

2016 ◽  
Vol 23 (04) ◽  
pp. 478-483
Author(s):  
Muhmmad Jameel Shahid ◽  
Faheem Ahmad ◽  
Muhammad Asif ◽  
Muhmmad Nabeel Sultan
Keyword(s):  
Diabetic Retinopathy ◽  
Macular Edema ◽  
Diabetic Macular Edema ◽  
Laser Photocoagulation ◽  
Pigment Epithelium ◽  
Retinal Pigment ◽  
Case Series ◽  
Visual Outcome ◽  
Blood Retinal Barrier ◽  
Department Of Ophthalmology

Regarding the causes of blindness, Diabetic retinopathy is a one the majorcause of blindness in all types persons from both industrialized and developing countries.Due to inadequate eating habits, prevalence of diabetic retinopathy is increasing. Both focaland diffuse leakage from retinal capillaries can cause Diabetic macular edema. Varioustreatment modalities for macular photocoagulation are focal laser, Grid laser and modified gridused in patients having diabetic macular edema Study Design: Prospective, interventional,noncompetitive case series. Setting: Department of Ophthalmology, Allied Hospital andDepartment of Ophthalmology, Divisional Headquarter Hospital Faisalabad. Period: One yearfrom April 2012 to April 2013. Materials and Methods: A total of 200 eyes of 200 patientswith clinical significant macular edema that met the inclusion criteria were enrolled. Results: Inthis study, 200 patients with diabetic macular edema were studied. Of these 121 (60.5%) weremales and 79 (39.5%) females with mean age of 38.52 years (SD 7.512, Range 25-50 years).All patients had diffuse, clinically significant macular edema at baseline for which they hadreceived grid laser photocoagulation. Discussion: In recent past number of diabetic patientsall over the world has increased that has caused increase incident of diabetic retinopathy .Soin patients having diabetic retinopathy, macular edema can cause deterioration in visual acuityduring any stage of diabetic retinopathy. The pathogenesis of Diabetic macular edema (DME)is the disruption of inner blood – retinal barrier that is known to be associated with metabolicalteration affecting the retinal pigment epithelium or retinal vascular endothelium. Focal and/orgrid laser photocoagulation is being considered as the treatment of DME. Conclusion: Macularphotocoagulation was found to be an effective method of treatment for CSME among diabeticpatients, which has resulted in a positive visual outcome in 87% of the patients (stable andimproved vision).

scholarly journals Comparative estimation of laser coagulation efficiency in macular and microphotocoagulation of high density in diabetic maculopathy treatment

2016 ◽  
Vol 9 (4) ◽  
pp. 43-45
Author(s):  
Tat’yana V Kotsur ◽  
Aleksandr S Izmaylov
Keyword(s):  
Retinal Pigment Epithelium ◽  
Side Effects ◽  
Macular Edema ◽  
Pigment Epithelium ◽  
Retinal Pigment ◽  
High Density ◽  
Laser Coagulation ◽  
Retinal Sensitivity ◽  
Diabetic Maculopathy ◽  
Laser Applications

Subthreshold microphotocoagulation (MicroPulase) leads to development of barely visible or invisible retinal burns and has been shown to be effective in macular edema treatment without any side effects inherent to the ETDRS method (atrophy of retinal pigment epithelium and choroid, decrease of retinal sensitivity). Microphotocoagulation efficacy may be increased by high density laser applications, however in modern literature rare publications draw attention to this matter.

scholarly journals Ο ρόλος των αντινεοαγγειακών παραγόντων στο διαβητικό οίδημα της ωχράς

2015 ◽  
Author(s):  
Ευαγγελία Παπαβασιλείου
Keyword(s):  
Diabetic Retinopathy ◽  
Macular Edema ◽  
Diabetic Macular Edema ◽  
Research Group ◽  
Early Treatment ◽  
Laser Photocoagulation ◽  
Study Research ◽  
Study Report

Η πιο συναρπαστική αλλαγή στη θεραπεία της διαβητικής αμφιβληστροειδοπάθειας ήταν με την έλευση της αντι-VEGF θεραπείας με ranibizumab (Lucentis, Genentech) για το διαβητικό οίδημα της ωχράς κηλίδας (DME) (Brown et al, 2013). Το πιο σημαντικό αποτέλεσμα που έδειξαν οι μελέτες RISE και RIDE είναι ότι οι ασθενείς με ΔOΩ που αφορά το κεντρικό βοθρίο έχουν μια πολύ καλή ευκαιρία να αυξήσουν σημαντικά την όρασή τους σε σχέση με ό,τι ήταν δυνατό να επιτύχουν με τη φωτοπηξία με λέιζερ. (Brown et al, 2013) O παράγοντας αντι-VEGF είναι η θεραπεία πρώτης γραμμής για το ΔOΩ με κεντρική συμμετοχή για πολλούς κλινικούς γιατρούς. Ωστόσο, για τους ασθενείς που παρουσιάζουν εντοπισμένο οίδημα που πληροί τα κριτήρια ETDRS, οι κλινικοί γιατροί θα πρέπει να χρησιμοποιούν το εστιακό laser (Photocoagulation for diabetic macular edema. Early Treatment Diabetic Retinopathy Study report number 1, Early Treatment Diabetic Retinopathy Study research group). Tα στοιχεία της οπτικής οξύτητας κατά τη μελέτη ETDRS έδειξαν ότι περίπου το 15% των ασθενών υπό θεραπεία με λέιζερ βελτιώθηκε κατά 3 γραμμές, ενώ στις μελέτες RIDE και RISE, περίπου σε 40% των ασθενών η οπτική οξύτητα βελτιώθηκε κατά 3 γραμμές με την αντι-VEGF θεραπεία. Στη μελέτη μας μπορέσαμε να δείξουμε ότι η συνδυαστική θεραπεία με λέιζερ και αντινεοαγγειακούς παράγοντες ήταν ανώτερη της μονοθεραπείας με λέιζερ. Ακόμα δείξαμε ότι η συνδυαστική θεραπεία ελάττωσε την ανάγκη για ένεσεις κατά τη διάρκεια του δεύτερου έτους θεραπείας και την ανάγκη για λέιζερ, με καλύτερα αποτελέσματα ως προς τη βέλτιστα διορθούμενη οπτική οξύτητα και το πάχος στην οπτική τομογραφία συνοχής. Προτείνουμε τηνέναρξη με τρεις μηνιαίες ενέσεις και λέιζερ κατά τον τρίτο μήνα. Στη συνέχεια προτείνουμε το συνδυασμό λέιζερ και αντι-VEGF όταν χρειάζεται. Βρήκαμε ότι υπάρχει ακόμα ένας ρόλος για το θερμικό λέιζερ στο ΔOΩ. Για το ΔOΩ που δεν αφορά το βοθρίο, και τα κυκλοτερή σκληρά εξιδρώματα η λέιζερ θεραπεία θεωρείται ακόμα η θεραπεία πρώτης γραμμής.

scholarly journals Latent Diabetic Macular Edema in Chinese Diabetic Retinopathy Patients

2021 ◽  
Vol 8 ◽  
Author(s):  
Xue Bai ◽  
Rui Hua
Keyword(s):  
Diabetic Retinopathy ◽  
Macular Edema ◽  
Diabetic Macular Edema ◽  
Foveal Thickness ◽  
Detection Rates ◽  
Central Foveal Thickness ◽  
Clinically Significant Macular Edema ◽  
Color Fundus Images ◽  
Vitreomacular Interface ◽  
Clinically Significant

Purpose: To compare the detection rates of optical coherence tomography (OCT) and fluorescein angiography (FA) in a diabetic macular edema (DME) and the severity of diabetic retinopathy in both color fundus images (CFI) and FA, and to investigate the predictive factors in macular leakages in FA.Methods: This was a retrospective study, and a total of 132 eyes of 77 patients with diabetic retinopathy were enrolled. Macular OCT, FA, and CFI were reviewed and measured. Central foveal thickness was also measured.Results: The severity of diabetic retinopathy in FA was significantly higher than that in CFI (p < 0.001). OCT detected 26 eyes with DMEs, which included the following: 13 eyes with cystoid macular edemas; 13 eyes with serous retinal detachments; 11 eyes with diffuse retinal thickening; 4 eyes with vitreomacular interface abnormalities. In contrast, 72 out of 132 eyes (54.5%) showed macular leakages in FA, which was significantly higher than that detected by OCT (p < 0.001). Compared with FA, the sensitivity and the specificity of OCT in detecting DMEs were 30.6 and 93.3%, respectively. However, central foveal thickness was not significantly different between the patients with non-clinically significant macular edema (CSME, 253.1 ± 26.95 μm) and slight CSME (270.9 ± 37.11 μm, p = 0.204). The mean central foveal thickness in diabetic macular edema (FA) eyes was 271.8 ± 66.02 μm, which was significantly higher than that (253. ± 25.21 μm) in non-DME (FA) eyes (p = 0.039). The central foveal thickness in DME (FA) eyes was significantly lower than that in eyes with DME (OCT) (p = 0.014). After adjusting for age and sex, a logistic regression analysis showed that the classification of diabetic retinopathy in FA was positively associated with macular leakage in FA (p < 0.001).Conclusions: The severity of diabetic retinopathy is underestimated in CFI compared with that in FA. FA can detect latent DMEs, which appeared normal on OCT. The central foveal thickness is not a sensitive parameter for detecting latent DMEs.

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