Literature DB >> 22762054

Is laser photocoagulation still effective in diabetic macular edema? Assessment with optical coherence tomography in Nepal.

Arjun Shrestha1, Deepak Khadka, Angira Karmacharya, Nhukesh Maharjan, Anand Shrestha, Raba Thapa, Govinda Poudyal.   

Abstract

AIM: To find out the outcome of laser photocoagulation in clinically significant macular edema (CSME) by optical coherence tomography (OCT)
METHODS: It was a prospective, non-controlled, case series study enrolling 81 eyes of 64 patients with CSME between August 2008 and January 2010. All patients received modified grid photocoagulation with frequency doubled Nd: YAG laser. Each patient was evaluated in terms of best-corrected visual acuity (BCVA) and regression or progression of maculopathy after laser therapy at 1, 3 and 6 months. Spearman's correlation test was used to show the correlation between BCVA and total macular volume (TMV). Analysis of variance (ANOVA) was used to compare among groups and independent t-test was used to compare in each group.
RESULTS: There is high correlation between BCVA and TMV (P≤0.001). BCVA improved in 50.6 %, remained static in 39.5% and deteriorated in 9.9% patients after 6 month of treatment. The Baseline TMV (mean and SD) were 9.26±1.83, 10.4±2.38), 11.5±3.05), 8.89±0.75 and 9.47±1.98mm(3) for different OCT patterns, ST (sponge like thickening), CMO (cystoid macular edema), SFD (subfoveal detachment), VMIA (Vitreo macular interface abnormality) and average TMV respectively (P=0.04). After 6 months of laser treatment, the mean TMV decreased from 9.47±1.98mm(3) to 8.77±1.31mm(3) (P=0.01). In ST there was significant decrease in TMV, P=0.01, Further within these groups at 6 months, they were significantly different, P=0.01.
CONCLUSION: OCT showed the different morphological variant of CSME while the response of treatment is different. TMV decreased the most and hence showed the improvement in vision after 6 months of laser treatment. In the era of Anti vascular endothelial growth factors (VEGFs), efficacy of laser seems to be in shadow but it is still first line of treatment in developing nation like Nepal where antiVEGFs may not be easily available and affordable.

Entities:  

Keywords:  Clinically significant macular edema; Grid laser photocoagulation; Optical coherence tomography; Total macular volume

Year:  2012        PMID: 22762054      PMCID: PMC3359042          DOI: 10.3980/j.issn.2222-3959.2012.02.20

Source DB:  PubMed          Journal:  Int J Ophthalmol        ISSN: 2222-3959            Impact factor:   1.779


  9 in total

1.  Morphological and functional analyses of diabetic macular edema by optical coherence tomography and multifocal electroretinograms.

Authors:  S Yamamoto; T Yamamoto; M Hayashi; S Takeuchi
Journal:  Graefes Arch Clin Exp Ophthalmol       Date:  2001-02       Impact factor: 3.117

2.  Optical coherence tomography after laser photocoagulation for clinically significant macular edema.

Authors:  M Rivellese; A George; D Sulkes; E Reichel; C Puliafito
Journal:  Ophthalmic Surg Lasers       Date:  2000 May-Jun

3.  Predictive factors for short-term visual outcome after intravitreal triamcinolone acetonide injection for diabetic macular oedema: an optical coherence tomography study.

Authors:  Oswaldo Ferreira Moura Brasil; Scott D Smith; Anat Galor; Careen Y Lowder; Jonathan E Sears; Peter K Kaiser
Journal:  Br J Ophthalmol       Date:  2006-11-15       Impact factor: 4.638

4.  Photocoagulation for diabetic macular edema. Early Treatment Diabetic Retinopathy Study report number 1. Early Treatment Diabetic Retinopathy Study research group.

Authors: 
Journal:  Arch Ophthalmol       Date:  1985-12

5.  Modified grid argon (blue-green) laser photocoagulation for diffuse diabetic macular edema.

Authors:  R J Olk
Journal:  Ophthalmology       Date:  1986-07       Impact factor: 12.079

Review 6.  Optical coherence tomography versus stereoscopic fundus photography or biomicroscopy for diagnosing diabetic macular edema: a systematic review.

Authors:  Gianni Virgili; Francesca Menchini; Andrea F Dimastrogiovanni; Emilio Rapizzi; Ugo Menchini; Francesco Bandello; Raffaella Gortana Chiodini
Journal:  Invest Ophthalmol Vis Sci       Date:  2007-11       Impact factor: 4.799

7.  Macular edema and cystoid macular edema.

Authors:  B S Fine; A J Brucker
Journal:  Am J Ophthalmol       Date:  1981-10       Impact factor: 5.258

8.  Techniques for scatter and local photocoagulation treatment of diabetic retinopathy: Early Treatment Diabetic Retinopathy Study Report no. 3. The Early Treatment Diabetic Retinopathy Study Research Group.

Authors: 
Journal:  Int Ophthalmol Clin       Date:  1987

9.  Effect of macular photocoagulation on visual acuity of Omani patients with clinically significant macular edema.

Authors:  Zafar A Zaidi; Mary K Jacob
Journal:  Oman J Ophthalmol       Date:  2009-05
  9 in total

北京卡尤迪生物科技股份有限公司 © 2022-2023.