Micropulse Laser Therapy Research Articles

Analysis of choriocapillaris perfusion and choroidal layer changes in patients with chronic central serous chorioretinopathy randomised to micropulse laser or photodynamic therapy

PurposeThe purpose of this study was to investigate the signal changes in choriocapillaris flow deficits and choroidal thickness changes using swept-source optical coherence tomography angiography (OCTA) following different treatments.DesignA double-blind,...

抗VEGF联合微脉冲激光按需治疗糖尿病性黄斑水肿的真实世界研究

抗VEGF联合微脉冲激光按需治疗糖尿病性黄斑水肿的真实世界研究

Zastosowanie laseroterapii mikropulsowej w obrzęku plamki związanym z zakrzepem gałęzi żyły środkowej siatkówki

It is estimated that the number of patients who each year experience the consequences of a branch retinal vein occlusion in Poland reaches 160,000 people. The part of them has an asymptomatic course, others are affected by decreased visual acuity caused by ischemia and subsequent macular edema. In confirmed cases, the intravitreal supply of the anti-VEGF preparation is recommended. Subthreshold micropulse laser therapy is a safe alternative in the early forms of macular edema in the branch retinal vein occlusion. The best therapeutic effects were achieved in patients with a time of onset not exceeding 6 months. In 5 out of 7 treated patients, an improvement in visual quality was observed after 4–8 weeks after laser treatment. Reduction of retinal thickness was noted in 6 patients. The safety and availability of micropulse laser therapy are an incentive for its use in patients with complications after branch retinal vein occlusion.

Metody leczenia cukrzycowego obrzęku plamki

Diabetic macular edema is one of the most serious ocular complications in diabetes. At present, several forms of therapy are available that are used depending on the severity of the lesions, the risk of complications, compliance and the availability. The anti-VEGF drugs have become the standard of choice and there are available three types: ranibizumab, aflibercept, and bevacizumab. The highest efficiency was proven in aflibercept. Other treatments include conventional lasers, steroid injections, subthreshold micropulse laser therapy and combinations of the above methods. It is important to cooperate with a diabetologist and encourage the patient to control levels of glycated hemoglobin, blood pressure, and lipid profile.

Treatment of diabetic macular edema with micropulse laser therapy

PurposeThe aim of the present study is to investigate the effect of Micropulse Laser Therapy (MP) in the treatment of diabetic macular edema (DME).MethodsForty eyes from 25 patients with clinically significant DME were included in the study. We used MP as first‐line therapy in cases of diffuse DME if central macular thickness (CMT) was < 300 μm.However, if DME was diffuse and CMT was >400 μm, we began anti‐VEGF therapy to reduce CMT and improve vision as quickly as possible.We started with MP also in patients who refused intravitreal anti‐VEGF injections, whom compromised systemically or those for whom they are not effective.Best corrected visual acuity (BCVA) and central macular thickness (CMT) were measured before, 3, 6 and 12 months after intervention, and the results were compared.ResultsMean age of our patients was 60,1 years. Mean BCVA was 0.67 ± 0.37 Logmar before treatment.After three months of MP, it improved to de 0.55 ± 0.4, p = 0.024. CMT was 511.79 μm, and improved to 481.8 μm (p: 0.055) at 3 month after treatment and to 410 μm at 6 months (p: 0.004) and 257.21 μm at 12 months (p = 0.002).OCT detected early retinal reflectivity changes after treatment. All patients reported subjective improvement. No adverse events were observed during follow‐upConclusionsIn this study, MP laser seems to be an effective laser to treat DME.Its attractive safety profile allows clinicians to offer earlier treatment to prevent tissue damage and the development of visual disability.

Retinal ellipsoid zone/external limiting membrane restoration after diabetic macular edema treatment

Purpose The aim of this study was to determine which clinically significant diabetic macular edema treatment modality results in early restoration of the ellipsoid zone and external limiting membrane (EZ/ELM). Patients and methods This was a retrospective study where the medical records of patients with type 2 diabetes mellitus and clinically significant diabetic macular edema were reviewed. Patients who had valid scans before treatment and 6 months after treatment were included. Disruption of EZ/ELM was graded and compared. Patients were divided into six groups according to the treatment received: group A received argon laser treatment; group B received micropulse diode laser treatment; group C received antivascular endothelial growth factor (anti-VEGF) treatment; group D received anti-VEGF+laser therapy; group E received triamcinolone acetonide injection (TAI); and group F received TAI+laser therapy. Results A total of 293 eyes of 200 patients were included (group A: 47, group B: 40, group C: 52, group D: 54, group E: 51, and group F: 49 eyes). Improvement in EZ/ELM integrity was 38.3% in group A, 45% in group B, 59.6% in group C, 37% in group D, 54.9% in group E, and 44.9% in group F. The difference between groups A and B was not statistically significant (P=0.3). The differences between group A and groups C, D, and E were statistically significant (P=0.002, 0.006, and 0.02, respectively). The difference between groups A and F was not significant (P=0.2). The difference between groups C and D was significant (P=0.001), whereas the difference between groups E and F was not significant (P=0.15). Conclusion Anti-VEGF monotherapy showed the highest percentage of early EZ/ELM restoration. Argon laser alone or argon laser combined with anti-VEGF delayed EZ/ELM healing. Micropulse laser therapy was equivalent to argon laser therapy. TAI results were comparable with anti-VEGF results. Laser addition did not compromise TAI results.

Improvement of diabetic macular edema after micropulse laser therapy

PurposeMicroPulse technology (MP) is a new technique using a subthreshold laser micropulse. The desired effect is to reduce the laser damage to ocular tissue; its application in the macular area is very promising in order to treat diabetic macular edema (DME) with the less retinal damage.We present our 6 months experience with MicroPulse Laser Therapy in DME using a new multifunctional laser, the IRIDEX IQ577.MethodsWe used MP as first‐line therapy in cases of diffuse DME if central macular thickness (CMT) was <300 μm. However, if DME was diffuse and CMT was >400 μm, we began anti‐VEGF therapy to reduce CMT and improve vision as quickly as possible. We began with the laser set in traditional settings. We placed a test spot in a non‐edematous area of the retina and we increased the power up moving to a new area each time, until we note a thermal reaction (white burn). In the second step, we switch the laser to the micropulse setting and perform MP over the area of edema with a high‐density grid treatment.ResultsTen eyes of 8 patients were included. Mean age at diagnosis was 63.5 years. Best‐corrected visual acuity was 0.88 logmar (range 1.7–0.3) before treatment. After three months of MP, it improved to 0.67 logmar (range 1.4–0.2), p: 0.002. CMT was 367 μm, and improved to 316.5 μm (p: 0.14) at 1 month after treatment and to 291.2 μm at 3 months (p: 0.04). OCT detected early retinal reflectivity changes after treatment. All patients reported subjective improvement. No adverse events were observed during follow‐up.ConclusionsMP laser is an effective laser to treat DME. Moreover, the attractive safety profile of MP treatment allows clinicians to offer earlier treatment to prevent tissue damage and the development of visual disability.

Comparison of therapeutic effect of micro-pulse laser and conventional laser on diabetic macular edema

Objective To compare the therapeutic effect of micro-pulse laser, single-spot laser and pattern scan laser for diabetic macular edema(DME). Methods Total of 120 eyes of 60 patients who were confirmed as preproliferative diabetic retinopathy or IV phase proliferative diabetic retinopathy complicated with clinically significant macular edema were included. These patients were randomized divided into the micro-pulse group with 40 eyes of 20 patients, the single-spot laser group with 40 eyes of 20 patients and the pattern scan laser group with 40 eyes of 20 patients.The patients in micro-pulse group underwent micro-pulse laser therapy in macular region , the single-spot laser group underwent macular laser grid photocoagulation therapy by single-spot laser, the pattern scan laser group underwent macular laser grid photocoagulation therapy by pattern scan laser.The BCVA, central macular thickness(CMT) and mean sensitivity(MS) of all patients were examined before and after the treatment. The changes in BCVA, CMT and MS at 6 months after treatment were observed and compared among the groups. Results At 6 months after the treatment, the BCVA of micro-pulse group increased more significantly compared to that before treatment(P 0.05). At 6 months after the treatment, the CMT of micro-pulse group, single-spot laser group and pattern scan laser group decreased significantly compared to those before treatment(P 0.05). At 6 months after the treatment, the MS of micro-pulse group increased significantly compared to that before treatment(P<0.05), the MS of single-spot laser group and pattern scan laser group decreased significantly compared to those before treatment(P<0.05), the MS of the three groups showed statistical difference (P<0.05). Conclusion Micro-pulse laser, single-spot laser and pattern scan laser therapies on DME can effectively reduce CMT and alleviate macular edema, micro-pulse laser therapy on DME also increase BCVA and MS, and improve visual function.Single-spot laser and pattern scan laser therapies can not improve visual function. Key words: Macular edema, diabetic; Micro-pulse laser; Laser coagulation; Effect, therapeutic

Comparison of yellow micro pulse photocoagulation and traditional laser grid photocoagulation for diabetic macular edema

Objective To compare the clinical results of yellow micro-pulse laser and traditional laser grid (MLG) photocoagulation for diabetic macular edema (DME).Methods Seventy-eight patients (106 eyes) with DME diagnosed by fundus fluorescein angiography (FFA) and optical coherence tomography (OCT) were enrolled in this study.The patients were divided into micro-pulse group (39 patients,51 eyes)and MLG group (39 patients,55 eyes).The patients of micro-pulse group underwent 577 nm yellow micropulse laser therapy,while the patients of MLG group underwent continuous wavelength laser photocoagulation with a 561 nm yellow green laser.All the patients were examined documenting corrected visual acuity,macular retinal thickness (CMT) and mean sensitivity within macular 10 ° examination before and after treatment.Six months after treatment was considered as the judgment time for the therapeutic effects.The mean corrected visual acuity,CMT and MS were comparatively analyzed.Results Six months after treatment,the mean corrected visual acuity of micro-pulse group and MLG group were 0.45±0.20 and 0.42±0.20,which increased significantly compared to those before treatment (t=3.404,2.316; P＜0.05).The difference of mean corrected visual acuity between before and after treatment of micro-pulse group and MLG group were 0.08 ± 0.02 and 0.06 ± 0.03,the difference was statistically significant between two groups (t=0.532,P＞0.05).The mean CMT of micro-pulse group and MLG group were (323.94 ± 68.30) and (355.85±115.88) μm,which decreased significantly compared to those before treatment (t=4.028,2.039; P＜0.05).The difference of mean CMT between before and after treatment of micro-pulse group and MLG group were (55.12±13.68) and (22.25±10.92) μm.The difference was not statistically significant between two groups (t=1.891,P＞0.05).The mean MS of micro-pulse group and MLG group were (6.63 ± 2.65) and (4.53 ± 1.81) dB.The mean MS of micro-pulse group increased significantly compared to that before treatment (t =3.335,P ＜ 0.05).The mean MS of MLG group decreased significantly compared to that before treatment (t=3.589,P＜0.05).The difference of mean MS between before and after treatment of micro-pulse group and MLG group were (1.10 ± 0.33) and (-0.91 ±0.25) dB.The difference was statistically significant between groups (t =4.872,P＜0.05).Conclusions In the treatment of DME,yellow micro-pulse laser therapy and MLG can improve visual acuity,and reduce CMT.In addition,yellow micro-pulse laser therapy can improve the MS,but MLG reduces MS. Key words: Diabetic retinopathy/therapy; Macular edema/therapy; Laser coagulation; Treatment outcome