Micropulse Laser Therapy Research Articles

Prognostic factors of visual outcome in central serous chorioretinopathy treated with subthreshold micropulse laser therapy.

Analyze the prognostic factors of visual outcome in central serous choriretinopathy (CSC) treated with subthreshold micropulse laser (SML) therapy through the most fundamental medical history and clinical examinations. It was a retrospective clinical study. We collected the most fundamental medical history and clinical examinations of CSC patients who received SML treatment, including visual acuity (VA) and spectral-domain optical coherence tomography (SD-OCT) of macular. Eyes were divided into two groups according the change of central macular thickness (CMT) before and one month after SML: CMT improvement and CMT deterioration group; divided into three groups according the change of VA: VA improvement, VA stability and VA decline group. Seventy-eight patients (eighty-three eyes) were enrolled. The baseline CMT was 339.83 ± 115.72μm, and the baseline VA was 0.43 ± 0.36. One month after SML, CMT was 281.13 ± 121.48μm, had a significant statistical improvement (p = 0.000); and VA was 0.46 + 0.42, had no significant statistical difference compared to baseline VA (p = 0.114). CMT of sixty-three eyes (75.90%) declined, and twenty eyes (24.10%) increased; VA of thirty-one eyes (37.35%) improved, fourteen eyes (16.87%) remained unchanged, and thirty-eight eyes (45.78%) declined. CMT and VA of twenty-seven eyes (32.53%) were both improved, and eleven eyes (13.25%) were both deteriorated. VA one month after SML was statistically correlated with age (p = 0.000), baseline VA (p = 0.000), and baseline CMT (P = 0.002). CMT and VA both improved one month after SML, and the improvement of CMT was more significant than VA. Elder age and poorer baseline vision indicated poorer VA one month after SML, while higher baseline CMT indicated better VA one month after SML.

Laser-Based Therapy Approaches in the Retina: A Review of Micropulse Laser Therapy for Diabetic Retinopathy.

This review aims to elucidate the mechanisms and clinical utility of subthreshold micropulse laser (SML) therapy in the context of retinal care. Subthreshold or "nondestructive" laser therapy encompasses treatment modalities that induce minimal or no harm to retinal or choroidal tissue and leave no visible sings post-application, while achieving clinical efficacy. A comprehensive review of literature sourced from databases including PubMed, Medline, Embase, Cochrane, and Web of Science was conducted, focusing on articles published before February 2024, and discussing the contemporary use of SML therapy in treating diabetic retinopathy (DR). The review presents evidence from scientific literature supporting SML therapy as a viable therapeutic approach for management of DR. Across numerous studies, SML therapy has demonstrated safety and additional therapeutic efficacy without causing damage to underlying retinal tissue. Subthreshold laser treatment emerges as a safe strategy for addressing DR. Numerous studies have shown its additional efficacy to anti-VEGF pharmacotherapy, which is the currently approved monotherapy for complications of DR. Ongoing research and clinical investigations aim to further elucidate the mechanisms and optimize the therapeutic advantages of this technology.

Settings and Clinical Applications of Subthreshold Micropulse Laser Therapy: A Review.

Subthreshold lasers operate below the threshold of visible tissue damage, thereby preventing ophthalmoscopically visible thermal damage to the chorio-retinal layers. They could represent a safe and effective alternative and/or adjunctive procedure to conventional lasers in treating diabetic macula edema (DME), central serous chorioretinopathy (CSCR), and branch retina vein occlusion (BRVO). This review focuses on the use of subthreshold micropulse laser (SMPL), its settings, and clinical applications. Despite their widespread use, a standardized protocol for sub-threshold laser settings has not been established yet, and thus, there is uncertainty in selecting effective and safe parameters for any specific situation. We conducted a comprehensive overview of the existing indications for subthreshold laser therapy and their settings for different retinal diseases. The debate revolves around which parameters could guarantee the safety of the procedure for each case, depending on the duty cycle, the laser wavelength, the spot duration, and the power, with laser power titration on one side or choosing a fixed lowered power value on the other side. SMPL therapy for DME, CSCR, and BRVO-associated macular edema has shown significant effectiveness in reducing the macular thickness, facilitating subretinal fluid absorptions, increasing the best corrected visual acuity (BCVA) and reducing the number of intravitreal injections (IVI) required annually. We presented a broad list of the laser parameters reported in the literature, organized into different tables divided based on the specific pathology, with the aim of providing a useful tool for future studies.

Management of Perifoveal Exudative Vascular Anomalous Complex.

To report a case of a patient with perifoveal exudative vascular anomalous complex (PEVAC) and to analyze morphological and vascular changes by OCT and OCTA before and after treatment. In this case we reported a case which received multiple treatment for unresponsive effect to Repeated Aflibercept intravitreal injections, subthreshold micropulse laser therapy (SMPL) duty cycle 5%. At last the focal fully dose yellow laser was performed. A 57-year-old male patient presented with best corrected visual acuity (BCVA) of 20/50 in his right eye (RE) The fundoscopic evaluation, structural optical coherence tomography (OCT) and OCT angiography (OCTA) deposed for a diagnosis of PEVAC. The patient underwent three Aflibercept intravitreal injections in the RE. Since no changes were detected, we opted for multiple sessions of yellow subthreshold micropulse laser therapy (SMPL) duty cycle 5%, however no signs of regression were registered. Only after a fully dose yellow laser, signs of edema regression were observed. Stuctural OCT B-scan showed complete restitutio of retinal profile, in absence of any intraretinal or subretinal fluid and PEVAC lesion, while the OCTA showed a slight flow deficit at the previous lesion site. and Importance: The PEVAC treatment is still unknown. In our experience, we reported a case of multiple treatments for unresponsive effect to: Aflibercept intravitreal injections, subthreshold micropulse laser therapy (SMPL) duty cycle 5%. At list the focal fully dose yellow laser was the only effective in our patient. We proposed our management to share the heterogeneous response at PEVAC entity.

Micropulse laser therapy in chronic idiopathic central serous chorioretinopathy in right eye of 38-year-old patient – case report

<b>WSTĘP:</b> Centralna chorioretinopatia surowicza (<i>central serous chorioretinopathy</i> – CSC) jest schorzeniem charakteryzującym się idiopatycznym surowiczym uniesieniem sensorycznej warstwy siatkówki w okolicy plamki, które najczęściej występuje jednostronnie, głównie u młodych mężczyzn ze zwiększoną podatnością na stres. Definiowanie optymalnego leczenia CSC jest skomplikowane ze względu na szeroki zakres objawów choroby, zmienny przebieg kliniczny, słabo poznaną patofizjologię CSC oraz brak konsensusu co do systemu klasyfikacji. W leczeniu CSC coraz częściej znajduje zastosowanie laser mikropulsowy, który działając selektywnie na nabłonek barwnikowy siatkówki, nie powoduje uszkodzeń fotoreceptorów. Celem pracy była ocena zastosowania terapii laserem mikropulsowym w leczeniu przewlekłego CSC. <b>OPIS I WYNIKI:</b> Pacjent 38-letni leczony od kilkunastu miesięcy z powodu nawracającego CSC w oku prawym, leczony miejscowo kroplami oraz lekami doustnymi. Ostrość wzroku pacjenta w chwili rozpoznania wynosiła 0,63, ciśnienie wewnątrzgałkowe 19 mmHg. Centralna grubość siatkówki w optycznej koherentnej tomografii (<i>optical coherence tomography</i> – OCT) wynosiła 530 µm. U pacjenta wykonano angiografię fluoresceinową (<i>fluorescein angiography</i> – FA) potwierdzającą rozpoznanie oraz zakwalifikowano go do laseroterapii siatkówki z użyciem mikropulsów. Podczas kontroli w badaniu FA uzyskano poprawę stanu klinicznego. Ostrość wzroku pacjenta wynosiła 1,0, ciśnienie wewnątrzgałkowe 17 mmHg. Uzyskano spadek centralnej grubość siatkówki w badaniu OCT do poziomu 299 µm. <b>WNIOSKI:</b> Zastosowanie lasera mikropulsowego umożliwia uzyskanie trwałego efektu klinicznego u pacjenta z przewlekłym nawracającym CSC.

Six-month results of 577 nm subthreshold micropulse laser therapy in non-center involving diabetic macular edema

BackgroundThis study aimed to evaluate the efficacy of 577 nm subthreshold micropulse laser (SML) therapy in patients with non-center involving diabetic macular edema (DME). MethodsTwenty-two eyes of 18 patients diagnosed with non-center involving DME were included in this prospective, observational study. The patient's baseline best corrected visual acuity (BCVA), maximum retinal thickness (MRT), central macular thickness (CMT), and the area of macular exudates were determined and re-evaluated at 1, 3, and 6 months after laser treatment. ResultsThere was no statistically significant change in BCVA at the 1st, 3rd and 6th months compared to the baseline in the follow-up (p = 0.067, p = 0.270, p = 0.027 according to Bonferroni correction p < 0,01). 1st, 3rd, and 6th month MRT was statistically significantly lower than baseline (p = 0,009, p = 0,006, p = 0,007). No statistically significant change was detected in CMT at the 1st, 3rd and 6th months compared to the baseline in the follow-up (p = 0.384, p = 0.794, p = 0.363). No statistically significant change in the area of macular exudates was detected at the 1st, 3rd, and 6th months compared to the baseline (p = 0.904, p = 0.444, p = 0.277). ConclusionsThis study observed a significant decrease in extrafoveal retinal thickness in patients with DME. There was no progression to central macular involvement, an increase in the area of exudates, and a decrease in BCVA in any patient. SML may be an effective alternative to conventional argon laser in non-center involving DME.

Subthreshold micropulse laser therapy for early postoperative macular thickening following surgical removal of epiretinal membrane

BackgroundThis study aimed to investigate the functional and anatomical outcomes of subthreshold micropulse laser (SMPL) therapy in eyes with early postoperative macular thickening after idiopathic epiretinal membrane (iERM) removal.MethodsThis was a prospective and interventional study. Forty-eight eyes from 48 patients with macular edema at 1 month after iERM removal were randomly divided into two groups. Patients in the SMPL group (n = 24) received SMPL therapy while no special intervention was used for the observation group (n = 24). Baseline demographic data and clinical findings before and at 1 and 3 months after SMPL treatment or observation, including best-corrected visual acuity (BCVA) and the changes in central subfield thickness (CST) and average macular thickness (AMT), were analyzed.ResultsAn improvement in BCVA with a decrease in CST and AMT from baseline to the 3-month follow-ups were observed in both SMPL and observation groups. No significant difference in BCVA was observed between the SMPL group and observation group either in the 1-month (0.26 [0.15, 0.52] vs. 0.26 [0.15, 0.39], P = 0.852) or the 3-month (0.15 [0.10, 0.30] vs. 0.23 [0.15, 0.30], P = 0.329) follow-up. There was a greater reduction in CST in the SMPL group versus observation group between baseline and the 3-month follow-up (-77.8 ± 72.3 μm vs. -45.0 ± 46.9 μm, P = 0.049). The alteration in AMT did not differ between the two groups in either 1-month (-16.5 ± 20.1 μm vs. -19.7 ± 16.3 μm, P = 0.547) or 3-month (-36.9 ± 26.9 μm vs. -34.0 ± 20.1 μm, P = 0.678) follow-up.ConclusionsSMPL therapy led to a significant decrease in CST at the 3-month follow-up while did not significantly improve the visual acuity in patients with postoperative macular thickening following iERM surgery.Trial registrationThe study was registered on Aug 27, 2020 (Trial Registration Number: ChiCTR 2000037227).

Evaluation of changes in macular structures after subthreshold micropulse laser therapy on chronic central serous chorioretinopathy.

To evaluate the changes in macular structures following subthreshold micropulse laser (SHML) treatment for chronic central serous chorioretinopathy (cCSC). Data of 33 eyes from 31 cCSC patients treated with SHML and followed up for at least 6 months has been included in this retrospective study. Main outcome measurements include resolution of subretinal fluid (SRF) and pigment epithelial detachment (PED), the recovery of ellipsoid zone (EZ) continuity, and the foveal outer nuclear layer (ONL) thickness along with its ratio. Mean observation period is 7.355 months (ranging from 6 to 24 months) and mean number of treatments administered is 1.839 (ranging from 1 to 5). 6 months after SHML treatment, there is a significant decrease in the area of SRF and PED (P < 0.001, P = 0.010, respectively). Additionally, the frequency of continuous EZ and the foveal ONL thickness reveal a significant increase (P<0.001, P = 0.005, respectively). The ratio of foveal ONL thickness is significantly higher after laser treatment, particularly in patients with a disease duration of ≤12 months (p = 0.022, P=0.036, respectively). SHML treatment proves to be effective in cCSC eyes, leading to satisfactory recovery of macular structures, especially the photoreceptor layer.

Micropulse Laser Therapy as an Integral Part of Eye Disease Management.

Ocular diseases can significantly impact vision and quality of life through pathophysiological alterations to the structure of the eye. The management of these conditions often involves a combination of pharmaceutical interventions, surgical procedures, and laser therapy. Laser technology has revolutionized many medical fields, including ophthalmology, offering precise and targeted treatment options that solve some of the unmet needs of other therapeutic strategies. Conventional laser techniques, while effective, can generate excessive thermal energy, leading to collateral tissue damage and potential side effects. Compared to conventional laser techniques, micropulse laser therapy delivers laser energy in a pulsed manner, minimizing collateral damage while effectively treating target tissues. The present paper highlights the advantages of micropulse laser therapy over conventional laser treatments, presents the implications of applying these strategies to some of the most prevalent ocular diseases, and highlights several types and mechanisms of micropulse lasers. Although micropulse laser therapy shows great potential in the management of ocular diseases, further research is needed to optimize treatment protocols, evaluate long-term efficacy, and explore its role in combination therapies.

Prognosis evaluation with optical coherence tomography in chronic central serous chorioretinopathy

BackgroundCentral serous chorioretinopathy (CSCR) is the fourth most common retinopathy that causes severe vision loss and is frequently seen in young and active patients. Our aim in this study is to evaluate whether a foresight about the prognosis of patients with CSCR can be obtained by optical coherence tomography (OCT) findings. Materials and methodsPatients diagnosed with chronic CSCR at Fatih Sultan Mehmet Research and Training Hospital, Ophthalmology Department, were screened between January 2017 and September 2019, and 30 patients were included in the study. The anatomical and functional changes of the patients during the 6-month follow-up and the relationship between the OCT findings at baseline and the best corrected visual acuity (BCVA) in the sixth month were evaluated. ResultsAll of the participants were treated with subthreshold micropulse laser therapy. BCVA increased significantly at first month and sixth month examinations compared to baseline, while the central macular thicknesses decreased significantly (p = 0.01, p = 0.00). Among the parameters examined in the baseline OCT, a positive correlation was found between the thickness of the outer nuclear layer (r = -0.520, p = 0.003) and BCVA at sixth month. In addition, subretinal fluid density and the number of intra-subretinal hyperreflective dots negatively affected BCVA (r = 0.371, p = 0.044 and r = 0.509, p = 0.004). ConclusionOuter nuclear layer thickness, subretinal fluid density and intra-subretinal hyperreflective dots were the OCT biomarkers related to sixth month BCVA. The clinical use of these biomarkers will help evaluate the prognosis of the CSCR.

Electrophysiological and anatomical outcomes of subthreshold micropulse laser therapy in chronic central serous chorioretinopathy.

To evaluate short-term efficacy of subthreshold micropulse laser therapy on chronic central serous chorioretinopathy (CSC) electrophysiologically and anatomically. This prospective study included 18 eyes with chronic CSC. Subthreshold micropulse laser therapy was applied to the eyes using Endpoint Management System (EpM). The efficacy of the treatment was evaluated with optical coherence tomography (OCT) and multifocal electroretinography (mfERG) measurements before and after one month of the treatment. The mean patient age was 47.3±5.7 years (ranged between 36 and 56). The mean symptomatic time of the disease was 12.7±3.33 months. Central macular thickness, choroidal thickness, subretinal fluid height and width showed statistically significant decreases after EpM treatment (p<0.05). P 1 amplitude of ring 1, 3, 4, and 5 in mfERG increased significantly (p< 0.05). The study demonstrated that, in both OCT and electrophysiological evaluations, EpM subthreshold laser therapy resulted in anatomical and functional improvements in chronic CSC.

Central Serous Chorioretinopathy or a stressful lifestyle predisposes to the disease? - review of the current literature

Central serous chorioretinopathy (CSCR) is a disease characterized by serous detachment of the neurosensory retina in the macular area, caused by increased choroidal vascular permeability. The disease is more common in young and middle-aged men (20-50 years old), it has been shown to be highly correlated with an increased level of stress in patients. Other risk factors for the central serous chorioretinopathy are: type A personality (ambitious, nervous and emotional people), use of steroids, Cushing’s syndrome, helicobacter pylori infection, gastroesophageal reflux, hypertension, sleep apnea. The disease leads to visual impairment: metamorphopsia, blurred vision, color vision impairment, impaired contrast and vision in the dark. CSCR diagnostics include funduscopic examination of the eye through the Volk lens revealing focus of circular retinal elevation, optical coherence tomography (OCT), which is a quick and non-invasive test that allows the diagnosis and monitoring of the disease. In the past, the diagnosis was based on fluorescein angiography, the dye spilling out fills the detachment space, revealing the leak center. In most cases the shunt stops spontaneously and spontaneous resorption of the subretinal fluid occurs without the need for treatment. The chronic form of CSCR ongoing more than 4 months requires initiation of therapeutic procedures. The first- line treatment is laser therapy. Micropulse laser therapy of the retina stimulates the pigment epithelium to produce anti-angiogenic factors and inhibit the inflammatory process, as a consequence, the resorption of the subretinal fluid occurs with minimal damage to the retina.

Diabetic Macular Edema and Diode Subthreshold Micropulse Laser: A Randomized Double-Masked Noninferiority Clinical Trial

To determine clinical effectiveness, safety, and cost-effectiveness of subthreshold micropulse laser (SML), compared with standard laser (SL), for diabetic macular edema (DME) with central retinal thickness (CRT) < 400 μm. Pragmatic, multicenter, allocation-concealed, double-masked, randomized, noninferiority trial. Adults with center-involved DME < 400 μm and best-corrected visual acuity (BCVA) of > 24 Early Treatment Diabetic Retinopathy Study (ETDRS) letters in one/both eyes. Randomization 1:1 to 577 nm SML or SL treatment. Retreatments were allowed. Rescue with intravitreal anti-vascular endothelial growth factor therapies or steroids was permitted if 10 or more ETDRS letter loss occurred, CRT increased > 400 μm, or both. Primary outcome was mean change in BCVA in the study eye at 24 months (noninferiority margin 5 ETDRS letters). Secondary outcomes were mean change from baseline to month 24 in binocular BCVA; CRT and mean deviation of Humphrey 10-2 visual field in the study eye; percentage meeting driving standards; EuroQoL EQ-5D-5L, 25-item National Eye Institute Visual Function Questionnaire (NEI-VFQ-25), and Vision and Quality of Life Index (VisQoL) scores; cost per quality-adjusted life-years (QALYs) gained; adverse effects; and number of laser and rescue treatments. The study recruited fully (n= 266); 87% of SML-treated and 86% of SL-treated patients had primary outcome data. Mean ± standard deviation BCVA change from baseline to month 24 was -2.43 ± 8.20 letters and -0.45 ± 6.72 letters in the SML and SL groups, respectively. Subthreshold micropulse laser therapy was deemed not only noninferior but also equivalent to SL therapy because the 95% confidence interval (CI; -3.9 to -0.04 letters) lay wholly within both upper and lower margins of the permitted maximum difference (5 ETDRS letters). No statistically significant difference was found in binocular BCVA (0.32 ETDRS letters; 95% CI, -0.99 to 1.64 ETDRS letters; P= 0.63); CRT (-0.64 μm; 95% CI, -14.25 to 12.98 μm; P= 0.93); mean deviation of the visual field (0.39 decibels (dB); 95% CI, -0.23 to 1.02 dB; P= 0.21); meeting driving standards (percentage point difference, 1.6%; 95% CI, -25.3% to 28.5%; P= 0.91); adverse effects (risk ratio, 0.28; 95% CI, 0.06-1.34; P= 0.11); rescue treatments (percentage point difference, -2.8%; 95% CI, -13.1% to 7.5%; P= 0.59); or EQ-5D, NEI-VFQ-25, or VisQoL scores. Number of laser treatments was higher in the SML group (0.48; 95% CI, 0.18-0.79; P= 0.002). Base-case analysis indicated no differences in costs or QALYs. Subthreshold micropulse laser therapy was equivalent to SL therapy, requiring slightly higher laser treatments.

Factors affecting the response to subthreshold micropulse laser therapy used in center-involved diabetic macular edema.

The purpose of this study was to investigate the effect of the status of retinal pigment epithelium (RPE) and HbA1c levels on the efficacy of the subthreshold micropulse laser (SMPL) in the treatment of center-involving diabetic macular edema (DME). A total of 20 eyes of 20 patients (mean age 57.9 ± 9.7years) who were diagnosed with center-involving DME and treated with SMPL for refusing intravitreal injection and 20 eyes of 20 age- and sex-matched healthy participants were enrolled. All patients were followed up in the 1st and 3rd months after SMPL. For measurement of RPE area central 1000 microns, macular EDI-OCT scans were binarized by using the public domain software ImageJ, with a semi-automated technique. There was a significant increase in BCVA values and a significant decrease in CMT values during follow-up. The area of RPE before SMPL was significantly thinner in the patient group (p: 0.004). When the areas of RPE before and 3months after SMPL were compared, no significant change was observed (p: 0.437). When the relationship between pre-treatment area of RPE and HbA1c was examined, an inverse correlation was observed (p: 0.018). The patients were evaluated by dividing them into 2 groups as 2nd session SMPL required and not required, and the area of RPE was smaller in the group requiring 2nd session SMPL (p: 0.030). The status of central RPE may be a determining factor on the response to treatment. Additionally, HbA1c levels may have an impact on treatment efficacy.

Blue Sclera as a Complication of Micropulse Transscleral Laser Therapy.

We report 3 patients who underwent micropulse laser therapy for glaucoma and subsequently developed a bluish-black discoloration of the sclera in a semicircular pattern corresponding to the probe path. This complication has not yet been reported with the micropulse laser treatment.

Применение микроимпульсной транссклеральной циклофотокоагуляции в лечении глаукомы. Предварительные результаты

Objective. To evaluate the preliminary results after micropulse cyclophotocoagulation in patients with primary open-angle refractory glaucoma (POAG) and neovascular glaucoma. Methods. Retrospective study of adult patients with glaucoma, with at least 6 months follow-up after the only one session of micropulse laser therapy. The study included 16 patients, 17 eyes with refractory primary open-angle glaucoma (POAG) and neovascular glaucoma. Follow up period was 6 months. The same surgical technique was used in all cases. The wavelength of the laser beam was 810 nm, the total exposure was 160 s, the energy was 2000 mJ, 31,3% of active cycle, the pulse duration was 0.5 ms, the period was 1.1 ms. Results. The average decrease in IOP was 26.6%. No complications identified Conclusions: micropulse transscleral cyclophotocoagulation has been shown to be safe and effective in lowering IOP in patients with refractory glaucoma. However, further study of this method is required. Key words: micrоpulse transscleral cyclophotocoagulation, glaucoma, intraocular pressure.

Pachychoroid diseases

The aim of this study is to present our knowledge about pachychoroid diseases using case reports, literature review and our own clinical experiences. A summary flow chart of treatment options for the subgroups was prepared, too. Pachychoroid diseases include the following: central serous chorioretinopathy (CSCR), pachychoroid pigment epitheliopathy (PPE), pachychoroid neovasculopathy (PNV), polypoidal choroidal vasculopathy (PCV), peripapillary pachychoroid syndrome (PPS), focal choroidal excavation (FCE). A common feature of pachychoroid diseases is the quantitative or qualitative abnormality of the choroidea, which is often associated with subretinal fluid accumulation. The disease group does not currently have a standard treatment protocol; some of the multiple treatments prove to be more effective, however, there are significant differences between the subgroups. We summarize which subgroup benefits from eplerenone tablet therapy, micropulse laser therapy, verteporfin photodynamic therapy or intravitreal anti-VEGF injection therapy. Orv Hetil. 2020; 162(20): 770-781.

Comparison of the efficacy and safety of anti-VEGF monotherapy versus anti-VEGF therapy combined with subthreshold micropulse laser therapy for diabetic macular edema.

The purpose of this study is to compare the efficacy and safety of 577-nm subthreshold micropulse laser (SML) and intravitreal bevacizumab injection (IVB) combined therapy with IVB monotherapy in the treatment of diabetic macular edema (DME). This retrospective study included 80 eyes of 80 patients; 40 eyes were treated with IVB monotherapy, and 40 eyes were treated with SML-IVB combined therapy. The mean number of required IVB injections and changes of best corrected visual acuity (BCVA) and central macular thickness (CMT) values were compared between the groups. The mean age of the patients was 60.19±7.43 years. The baseline characteristics of the patients were similar between the groups. In the SML-IVB combined group, the mean number of required SML sessions was 2.1±0.81. The mean number of required IVB injections was 4.38±0.81 in the SML-IVB combined group and 5.65±1.51 in the IVB monotherapy group (p<0.05). The increase of the BCVA was significant in the SML-IVB combined group at the 3rd, 6th, 9th, and 12th months; however, in the IVB monotherapy group, it was only significant at the 3rd month (p<0.05). The mean CMT values of the 3rd, 9th, and 12th months were similar between the groups (p>0.05); only at the 6th month was it significantly lower in the SML-IVB combined group (p<0.05). When compared with baseline, the decrease of the CMT was statistically significant in both groups at the 3rd, 6th, 9th, and 12th months (p<0.05). In this study, a significant benefit of adding SML to IVB therapy was found with less IVB need, although a very significant increase in BCVA could not be achieved. The use of SML-IVB combined treatment may be an effective and safe alternative for DME.

Macular function and structure in patients with center-involved diabetic macular edema before and after micropulse laser therapy

ENWEndNote BIBJabRef, Mendeley RISPapers, Reference Manager, RefWorks, Zotero AMA Nowacka B, Mozolewska-Piotrowska K, Lubiński W, Machalińska A, Grabowicz A. Macular function and structure in patients with center-involved diabetic macular edema before and after micropulse laser therapy. Klinika Oczna / Acta Ophthalmologica Polonica. 2021;123(2):90-95. doi:10.5114/ko.2021.105631. APA Nowacka, B., Mozolewska-Piotrowska, K., Lubiński, W., Machalińska, A., & Grabowicz, A. (2021). Macular function and structure in patients with center-involved diabetic macular edema before and after micropulse laser therapy. Klinika Oczna / Acta Ophthalmologica Polonica, 123(2), 90-95. https://doi.org/10.5114/ko.2021.105631 Chicago Nowacka, Barbara, Katarzyna Mozolewska-Piotrowska, Wojciech Lubiński, Anna Machalińska, and Aleksandra Grabowicz. 2021. "Macular function and structure in patients with center-involved diabetic macular edema before and after micropulse laser therapy". Klinika Oczna / Acta Ophthalmologica Polonica 123 (2): 90-95. doi:10.5114/ko.2021.105631. Harvard Nowacka, B., Mozolewska-Piotrowska, K., Lubiński, W., Machalińska, A., and Grabowicz, A. (2021). Macular function and structure in patients with center-involved diabetic macular edema before and after micropulse laser therapy. Klinika Oczna / Acta Ophthalmologica Polonica, 123(2), pp.90-95. https://doi.org/10.5114/ko.2021.105631 MLA Nowacka, Barbara et al. "Macular function and structure in patients with center-involved diabetic macular edema before and after micropulse laser therapy." Klinika Oczna / Acta Ophthalmologica Polonica, vol. 123, no. 2, 2021, pp. 90-95. doi:10.5114/ko.2021.105631. Vancouver Nowacka B, Mozolewska-Piotrowska K, Lubiński W, Machalińska A, Grabowicz A. Macular function and structure in patients with center-involved diabetic macular edema before and after micropulse laser therapy. Klinika Oczna / Acta Ophthalmologica Polonica. 2021;123(2):90-95. doi:10.5114/ko.2021.105631.

The efficacy of subthreshold micropulse yellow laser (577 nm) in chronic central serous chorioretinopathy.

Central serous chorioretinopathy (CSC) is a disease characterized by a well-defined serous detachment of the neurosensory retina. Therapeutic options in chronic cases are limited, and side effects can result in a limited response. The aim of this article is to assess the efficacy of subthreshold micropulse laser therapy in patients with chronic central serous chorioretinopathy. The study included 20 eyes of 19 patients who had a history of chronic or chronic recurrent CSC and who underwent subthreshold micropulse laser therapy between January 2015 and June 2018. Twenty eyes of 19 patients with a mean age of 48.9 ± 9.40 years were included. The mean visual acuity was 0.24 ± 0.28 logMAR before laser, 0.19 ± 0.25 logMAR 3 months after laser, and 0.18 ± 0.27 logMAR after 6 months. A statistically significant difference was determined in terms of visual acuity before and after treatment (p = 0.0001). The mean central retinal thickness was 308.10 ± 95.25 μm before laser, 233.65 ± 81.17 μm 3 months after laser, and 203.88 ± 72.79 μm at 6 months. A statistically significant relationship was present between visual acuity and the duration of disease (p = 0.001), between visual acuity and the outer nuclear layer thickness (p = 0.005), and between the outer nuclear layer thickness and the duration of disease in chronic cases (p = 0.008). There was no evidence of retinal pigment epithelium or retinal damage on optical coherence tomography or fundus autofluorescence secondary to subthreshold micropulse laser therapy. Visual acuity appears to be more associated with the duration of disease and with changes in the outer nuclear layer thickness in chronic CSC. Subthreshold micropulse laser therapy seems to be effective at treating chronic CSC, while it increases success during early period of the disease before the development of permanent retinal damage.