Технология комбинированного лазерного лечения диабетического макулярного отека. Первые результаты

Abstract

Purpose. To assess preliminary clinical outcomes of combined laser treatment technology in patients with diabetic macular edema (DME). Material and methods. Six eyes of five patients with clinically significant diabetic macular edema were enrolled. The combined laser technology used a yellow wavelength (577nm) and included a combination of modified ETDRS focal/grid photocoagulation (mETDRS) and subthreshold micropulse yellow laser photocoagulation (SMYLP). The SMYLP was performed simultaneously with the mETDRS at the initial treatment and alone at the 1-month follow-up with laser settings adjusted individually in each case. All patients underwent the standard examination complemented with modern diagnostic techniques such as spectral-domain optical coherence tomography (OCT), fluorescein angiography, autofluorescence (AF), computer microperimetry (MP) at the baseline, 1- and 3-month follow-up. Results. The mean central retinal thickness decreased from the preoperative 393.5±116.9µm to 339.0±73.1µm at the 3-month follow-up. Resorption of macular edema was associated with the mean best corrected visual acuity (BCVA) improvement from 0.55±0.1 to 0.65±0.2. The mean central retinal sensitivity gradually increased from 11.2±2.4dB to 11.6±3.2dB after 3 months. Conclusion. The developed combined laser treatment technology in DME management has demonstrated promising clinical and functional outcomes resulting in the macular edema resorption and the central retinal sensitivity improvement in the short-term follow-up (3 months). One of the most prominent features of this technology is a foveal repetitive treatment possibility owing to a high selectivity of SMYLP to retinal pigment epithelium. Further clinical investigations are required to evaluate the efficacy and safety of the combined laser technology compared with the conventional laser treatment.