scholarly journals Role of focal laser retinal photocoagulation in treatment of diabetic macular edema

2021 ◽  
Vol 38 (2) ◽  
pp. 56-69
Author(s):  
I. V. Ionkina ◽  
A. G. Grinev ◽  
O. M. Zherebtsova

Vascular endothelial growth factor (anti-VEGF) inhibitors in action have demonstrated efficacy and safety in the treatment of diabetic macular edema (DME), and have changed both the goal and prospects for treatment of this disease. Consequently, the role of focal laser retinal photocoagulation in the treatment of DME has been actively debated. However, technical advances in new laser systems, treatment protocols for anti-VEGF drug research, and the functional impact of modern focal photocoagulation are necessary to assess the role of laser coagulation in the treatment of DME. A wide range of clinical studies of laser therapy was necessary as an additional treatment for 20 to 50 % of patients receiving monotherapy with anti-VEGF drugs in patients with diabetic macular edema. In addition, a lower frequency of repeated treatment and a more stable reduction in retinal thickness have been demonstrated in other studies. However, the lack of information about the laser systems used, their technical characteristics, and application protocols often make it difficult to compare directly the results of anti-VEGF tests. Therefore, the aim of our work was to analyze the currently available data related to the potential role of focal laser photocoagulation in the treatment of DME, including a detailed review of the most commonly used laser systems. The results obtained with sub-threshold diode micro-pulse laser photocoagulation may be a valuable option as an adjunct therapy to treatment with angiogenesis inhibitors. Current evidence suggests that focal laser therapy should still exist as an adjunct therapy for many patients.

2019 ◽  
Vol 35 (6) ◽  
Author(s):  
Weizhe Meng ◽  
Ronghua Li ◽  
Xiufen Xie

Objective: To explore the clinical efficacy of intravitreal injection of conbercept in combination with retinal laser photocoagulation in the treatment of diabetic macular edema. Methods: Ninety patients with diabetic macular edema were selected and grouped into an observation group and a control group using random number table, 45 patients (45 eyes) each group. The control group was given retinal laser photocoagulation, while the observation group was given intravitreal injection of Conbercept on the basis of panretinal photocoagulation. The Best Corrected Visual Acuity (BCVA), thickness of retinal nerve fibre layer (RNFL) and macular thickness were measured through relevant examinations before and after treatment. The intraocular pressures of patients in the two groups were evaluated, and moreover the complications were recorded. Results: The RNFL thickness and macular thickness of the two groups had no statistically significant differences before treatment (P>0.05) and decreased significantly after treatment; the decrease amplitude of the observation group was significantly larger than that of the control group (P<0.05). The BCVA of both groups significantly increased in the 1st, 2nd and 4th week after treatment (P<0.05); the increase amplitude of BCVA of the observation group was more significant than that of the control group at different time points after treatment (P<0.05). The intraocular pressure of the observation group was not significantly different with that of the control group in the 1st, 2nd and 4th week after treatment (P>0.05). There were no severe eye complications and systemic adverse reactions in both groups in the process of follow up. Conclusion: Intravitreal injection of conbercept in combination with retinal laser photocoagulation performs better in improving the BCVA and central macular thickness of patients with diabetic macular edema compared to retinal laser photocoagulation and has high safety. doi: https://doi.org/10.12669/pjms.35.6.512 How to cite this:Meng W, Li R, Xie X. Conbercept and Retinal Photocoagulation in the treatment of Diabetic Macular Edema. Pak J Med Sci. 2019;35(6):1493-1498. doi: https://doi.org10.12669/pjms.35.6.512 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


2014 ◽  
Vol 07 (01) ◽  
pp. 59
Author(s):  
Marcus Kernt ◽  
Michael Ulbig ◽  
Anselm Kampik ◽  
Aljoscha S Neubauer ◽  
◽  
...  

Navigated laser therapy introduces computerized assistance systems to retinal laser photocoagulation treatment. The Navilas system offers high precision and safety and provides additional advantages regarding standardization of planning, execution, documentation, quality assurance, and better overall treatment comfort for the patient as main benefits over conventional laser. Navigated laser therapy is being used with good success in the treatment of diabetic macular edema (DME), retinal vein occlusions (RVO), and fast-pattern navigated panretinal photocoagulation in proliferative diabetic retinopathy (PDR). In center-involving DME, a combination of anti-vascular endothelial growth factor (VEGF) and macular laser may provide advantages over anti- VEGF monotherapy. In terms of navigated laser therapy, recent study data from our clinic and other institutions indicate that combined initial anti-VEGF and navigated macular laser therapy allows treatment success to be achieved and maintained with a significantly reduced number of interventions.


2017 ◽  
Vol 2017 ◽  
pp. 1-9 ◽  
Author(s):  
Bora Eldem ◽  
Sengul Ozdek ◽  
Ali Osman Saatci ◽  
Emin Ozmert ◽  
Esat Ulay ◽  
...  

Purpose. To evaluate the clinical and diagnostic characteristics of patients with newly diagnosed diabetic macular edema (DME) in Turkey in a real-life setting. Methods. A total of 945 consecutive patients (mean (SD) age: 61.3 (9.9) years, 55.2% male) with newly diagnosed DME were included. Data on patient demographics, comorbidities, ocular history, ophthalmic examination findings including type of DME, central macular thickness (CMT) via time domain (TD) and spectral domain (SD) optical coherence tomography (OCT), and planned treatments were recorded. Results. OCT (98.8%) and fundoscopy (92.9%) were the two most common diagnostic methods. Diffuse and focal DMEs were detected in 39.2% and 36.9% of cases, respectively. Laser photocoagulation (32.1%) and antivascular endothelial growth factors (anti-VEGF; 31.8%) were the most commonly planned treatments. The median CMT in the right eye was significantly greater in untreated than in treated patients [376.5 μm (range: 160–840) versus 342 μm (range: 146–999) (p=0.002)] and in the left eye [370 μm (range: 201–780) versus 329 μm (range: 148–999) (p<0.001)]. Conclusions. This study is the first large-scale real-life registry of DME patients in Turkey. SD-OCT and fundoscopy were the most common diagnostic methods. Laser photocoagulation and anti-VEGF therapy were the most common treatments.


2011 ◽  
Vol 1 ◽  
pp. 58-62
Author(s):  
Vishali Gupta ◽  
Deeksha Katoch ◽  
Anil Bhansali ◽  
Swapnil Parchand ◽  
Amod Gupta

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