scholarly journals Non-Damaging Retinal Laser Therapy in Recurrent Diabetic Macular Edema after Anti-VEGF injections.

2021 ◽  
Keyword(s):  
Macular Edema ◽  
Laser Therapy ◽  
Diabetic Macular Edema ◽  
Anti Vegf

Navigated Laser Therapy for Diabetic Macular Edema

2014 ◽  
Vol 07 (01) ◽  
pp. 59
Author(s):  
Marcus Kernt ◽  
Michael Ulbig ◽  
Anselm Kampik ◽  
Aljoscha S Neubauer ◽  
◽  
...  
Keyword(s):  
Macular Edema ◽  
Laser Therapy ◽  
Diabetic Macular Edema ◽  
Treatment Success ◽  
Study Data ◽  
Panretinal Photocoagulation ◽  
Documentation Quality ◽  
Anti Vegf ◽  
Navigated Laser ◽  
Photocoagulation Treatment

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.

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
Keyword(s):  
Macular Edema ◽  
Laser Therapy ◽  
Diabetic Macular Edema ◽  
Laser Photocoagulation ◽  
Current Evidence ◽  
Adjunct Therapy ◽  
Anti Vegf ◽  
Laser Systems ◽  
Retinal Photocoagulation

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.

scholarly journals Treatment results of nondamaging retinal laser therapy in diabetic macular edema

2022 ◽  
Vol 14 ◽  
pp. 251584142110632
Author(s):  
Burcu P. Gültekin
Keyword(s):  
Visual Acuity ◽  
Macular Edema ◽  
Laser Therapy ◽  
Diabetic Macular Edema ◽  
Intravitreal Injections ◽  
Diabetic Patients ◽  
Efficacy And Safety ◽  
Anti Vegf ◽  
Significant Difference ◽  
The Mean

Background: Subthreshold nondamaging retinal laser therapy (NRT) provides a greater safety profile than conventional laser methods, but more data is needed on the efficacy and safety of subthreshold NRT in diabetic macular edema. Purpose: To evaluate the efficacy and safety of NRT for the treatment of clinically significant macular edema (CSME) that is partially responsive or resistant to intravitreal anti-vascular endothelial growth factor (anti-VEGF) treatment. Methods: This was a retrospective case series study. Fifty eyes of 38 diabetic patients with CSME previously treated with at least 6-monthly intravitreal bevacizumab injections with/without intravitreal Ozurdex therapy were evaluated. The patients received 577-nm yellow wavelength laser therapy with PASCAL laser system (Topcon Medical Laser Systems, Santa Clara, CA, USA). Best-corrected visual acuity (BCVA) and central subfield thickness (CST) were evaluated before and 1, 3, 6, 12 and 24 months after laser treatment. Results: Baseline mean CST was 368.06 ± 86.9 µm. The mean CST values at the 1-, 3-, 6-, 12-, and 24-month visits were 336.93 ± 79.8, 352.40 ± 113.5, 336.36 ± 109.3, 325.10 ± 104 µm, and 310.08 ± 84.7 µm, respectively. The mean CST decreased significantly at the first ( p = 0.002) and second year visits ( p < 0.001) when compared with pretreatment values. Although visual acuity was improved at the first year compared with baseline, this difference was not statistically significant ( p = 0.03). There was no significant difference in visual acuities between pretreatment and posttreatment visits. During 24-month follow-up, while 37 eyes were treated with [mean: 5.7 ± 3.4 (1–14)] intravitreal anti-VEGF injections, 3 eyes were administered single-dose intravitreal steroids. Additional intravitreal injections were not required in 10 (20%) eyes. Conclusion: NRT is effective by itself or in combination with anti-VEGF agents in diabetic macular edema that is partially responsive or resistant to previous intravitreal injections. T role in treating this disorder should be assessed in more detail with prospective controlled studies.

Change in Visual Acuity in Relation to Central Macular Thickness after Intravitreal Bevacizumab in Diabetic Macular Edema

2020 ◽  
Vol 36 (3) ◽  
Author(s):  
Muhammad Ali Haider ◽  
Uzma Sattar ◽  
Syeda Rushda Zaidi
Keyword(s):  
Visual Acuity ◽  
Macular Edema ◽  
Diabetic Macular Edema ◽  
Intravitreal Bevacizumab ◽  
Macular Thickness ◽  
Rank Test ◽  
P Value ◽  
Central Macular Thickness ◽  
Anti Vegf ◽  
Quasi Experimental

Purpose: To evaluate the change in visual acuity in relation to decrease in central macular thickness,after a single dose of intravitreal Bevacizumab injection.Study Design: Quasi experimental study.Place and Duration of Study: Punjab Rangers Teaching Hospital, Lahore, from January 2019 to June 2019.Material and Methods: 70 eyes with diabetic macular edema were included in the study. Patients having high refractive errors (spherical equivalent of > ± 7.5D) and visual acuity worse than +1.2 or better than +0.2 on log MAR were excluded. Central macular edema was measured in μm on OCT and visual acuity was documentedusing Log MAR chart. These values were documented before and at 01 month after injection with intravitrealBevacizumab. Wilcoxon Signed rank test was used to evaluate the difference in VA beforeand after the anti-VEGF injection. Difference in visual acuity and macular edema (central) was observed,analyzed and represented in p value. P value was considered statistically significant if it was less than 0.01%.Results: Mean age of patients was 52.61 ± 1.3. Vision improved from 0.90 ± 0.02 to 0.84 ± 0.02 on log MARchart. The change was statistically significant with p value < 0.001. Central macular thickness reduced from 328 ±14 to 283 ± 10.6 μm on OCT after intravitreal anti-VEGF, with significant p value < 0.001.Conclusion: A 45 μm reduction in central macular thickness was associated with 0.1 Log MAR unit improvementin visual acuity after intravitreal Bevacizumab in diabetic macular edema.

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