Application of Micro-Pulse and Continuous Laser Radiation in Navigation Topographically-Oriented Treatment of Focal Diabetic Macular Edema Based

Abstract

Purpose: to evaluate the clinical efficacy of subthreshold laser treatment of focal DME in continuous and micro-pulse modes using a navigation system based on OCT-A data.Methods. 33 patients (33 eyes) with focal DME were under observation before and after laser treatment. All patients underwent high-resolution OCT-A using the HD Angio Retina 6×6 mm protocol on RTVue-100 XR Avanti (Optovue, USA) and SOLIX (Optovue, USA) devices. The height of edema in the fovea averaged 304.5 ± 5.4 um in the group, in the area of edema outside the fovea — 336.5 ± 7.5 um. The initial best corrected visual acuity (BCVA) was 0.75 ± 0.06. The central retinal sensitivity (CRS) before treatment was 24.10 ± 0.48 dB. The treatment was carried out on the NAVILAS 577S navigation laser system (“OD-OS”, Germany). The results were evaluated within 1, 3 and 6 months after treatment.Results. 1 month after laser treatment, the average CRT in the group was: in the fovea — 294.00 ± 5.38 um, outside the fovea — 318.50 ± 6.44 um. The BCVA increased on average to 0.80 ± 0.06; the CRS to 24.65 ± 0.47 dB. After 3 months, a further decrease in the height of edema was observed (CRT in the fovea was 252.50 ± 2.19 microns, outside the fovea 280.50 ± 3.75 microns). The BCVA increased on average in the group to 0.85 ± 0.06, CRS — 25.50 ± 0.30 dB. After 6 months, the average CRT in the group was: in the fovea — 246.50 ± 1.81 microns, outside the fovea — 273.50 ± 4.56 microns. A stable increase in the BCVA indicators was achieved — 0.85 ± 0.06 and CRS — 26.65 ± 0.16 dB. At the time of 1.3 and 6 months after treatment, an increase in vascular density was observed in the deep vascular complex and the superficial vascular plexus.Conclusion. The preliminary results obtained by us indicate the effectiveness of navigation sub-threshold laser treatment of DME in the micro-pulse and continuous modes, based on targeted topographicallyoriented laser exposure according to OCT angiography.