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CLINICAL AND FUNCTIONAL FEATURES OF SUBTHRESHOLD MICROPULSE LASER TREATMENT IN “FLAT” DIABETIC MACULAR EDEMA MANAGEMENT

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Aim : to compare clinical and functional outcomes of subthreshold micropulse yellow (577 nm) laser photocoagulation versus conventional modified ETDRS laser photocoagulation in «flat» diabetic macular edema treatment Methods : forty one eye of forty eight patients with clinically significant diabetic macular edema (DME) according ETDRS classification were enrolled. The term «flat» DME we used to describe cases of DME with the presence of diffuse retinal thickening (DRT), central retinal thickness (CRT) < 400 µm with/or small intraretinal cysts in outer retinal layers (ONL). Exclusion criteria were: CRT > 400 µm with/or the presence large cysts in inner retinal layers and serous retinal detachment. Patients in main group (22 eyes) undergone SMYLP while mETDRS laser photocoagulation in control group was performed. Results : mean CRT in main group decreased from 327.5 ± 39.8 µm to 278.6 ± 29.2 µm ( p < 0.05) with subsequent increase of the mean best corrected visual acuity (BCVA) and central retinal sensitivity (RS) from 13.6 ± 3.3 dB to 15.3 ± 2.8 dB, respectively ( p < 0.05) at 12-month follow-up. In control group our results showed similar improvement in BCVA and CPT values at 12-month follow-up (from 0.57 ± 0.17 to 0.62 ± 0.17 and from 344.9 ± 31.9 µm to 312.7 ± 40.9 µm respectively, p < 0.05). RS value, in contrary, decreased from 13.2 ± 2.4 dB to 11.5 ± 2.6 dB ( p < 0.05). The comparison between groups revealed more stable positive dynamics in main group while in controls there was a slight regression of values achieved at 6-month follow-up. Conclusions : SMYLP appears to be safe and effective in “flat” DME treatment with DRT < 400 µm and/or the presence of small intraretinal cysts in ONL. SMYLP demonstrates higher positive dynamics accompanied with RS improvement compared to conventional mETDRS laser photocoagulation at 12-month follow-up.

Keywords

subthreshold micropulse yellow laser photocoagulation; cystoid macular edema; diffuse retinal thickening; laser photocoagulation; optical coherence tomography; microperimetry

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DOI

10.20310/1810-0198-2016-21-4-1511-1516

UDC

617.736

Pages

1511-1516

References

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Received

2016-03-18

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Scholarly articles

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