Comparison of the 1-Year Visual and Anatomical Outcomes between Subthreshold Red (670 nm) and Yellow (577 nm) Micro-Pulse Laser Treatment for Diabetic Macular Edema

Kenji Kashiwagi,Wataru Kikushima,Yukiko Furuhata,Taiyo Shijo,Yoichi Sakurada

doi:10.3390/ph14111100

Kenji Kashiwagi, Wataru Kikushima

Open Access

https://doi.org/10.3390/ph14111100

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Journal: Pharmaceuticals	Publication Date: Oct 28, 2021
Citations: 6	License type: CC BY 4.0

Affiliation: University of Yamanashi

Abstract

We investigated the efficacy and safety of red (670 nm) subthreshold micropulse laser (SMPL) treatment for diabetic macular edema (DME) and compared the 1-year treatment outcomes of red and yellow (577 nm) SMPL for DME. A medical chart review was performed in 43 consecutive eyes of 35 patients who underwent red or yellow SMPL treatment for DME and were followed up for 12 months. There were 26 and 17 eyes in the yellow and red SMPL groups, respectively. The mean best-corrected visual acuity (BCVA) was maintained throughout the follow-up period of 12 months in the yellow and red SMPL groups (p = 0.39, p = 0.70, respectively). The central retinal thickness (CRT) measured by spectral-domain optical coherence tomography (SD-OCT) was significantly decreased at 12 months from baseline in the yellow and red SMPL groups (p = 0.047, p = 0.03, respectively). Although the amount of CRT reduction in the red SMPL group was significantly greater than that in the yellow SMPL group at 8 months from baseline (p = 0.02), the significance disappeared at the final follow-up period (p = 0.44). The red SMPL maintained the BCVA in patients with center-involving DME. The mean CRT in the red SMPL group significantly decreased, and the amount of CRT reduction was equivalent to that in the yellow SMPL group.

Highlights

Diabetic macular edema (DME) is a complicated pathology that can appear even in the early stage of diabetic retinopathy and can cause a mild to moderate reduction in the visual acuity of the patients [1]
Several treatment options have been reported in past studies to handle diabetic macular edema (DME), including partial photocoagulation [2], sub-Tenon’s/intravitreral triamcinolone acetonide injection [3], intravitreal anti-vascular endothelial growth factor (VEGF) agent injection [4,5], vitrectomy [6,7], intravitreal dexamethasone implant [8,9], and combinations of these treatment protocols [10]
Subthreshold micropulse laser treatment (SMPL) was first reported by Friberg and Karatza as a non-invasive laser treatment directly targeting the macular area with a wavelength of 810 nm for DME [11]

Summary

Introduction

Diabetic macular edema (DME) is a complicated pathology that can appear even in the early stage of diabetic retinopathy and can cause a mild to moderate reduction in the visual acuity of the patients [1]. Several treatment options have been reported in past studies to handle DME, including partial photocoagulation [2], sub-Tenon’s/intravitreral triamcinolone acetonide injection [3], intravitreal anti-vascular endothelial growth factor (VEGF) agent injection [4,5], vitrectomy [6,7], intravitreal dexamethasone implant [8,9], and combinations of these treatment protocols [10]. Subthreshold micropulse laser treatment (SMPL) was first reported by Friberg and Karatza as a non-invasive laser treatment directly targeting the macular area with a wavelength of 810 nm (infrared SMPL) for DME [11]. Few studies reported the comparison of the effects of SMPL and other treatment options for DME. Wu et al reported that the combination of intravitreal anti-VEGF therapy and conventional laser photocoagulation therapy was more effective than infrared

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