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Shanu Subbiah, Mark Donaldson, Monika Pradhan; Tissue sparing micropulse laser for the treatment of diabetic macular oedema. Invest. Ophthalmol. Vis. Sci. 2013;54(15):2382. doi: https://doi.org/.
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Tissue sparing micropulse retinal laser can be used for the treatment of diabetic macular oedema. It allows the tissue to cool between laser pulses, minimizing tissue damage. Treatment risks are reduced, with increased patient comfort than with conventional, continuous-wave laser treatment. This prospective non-comparative case series studied the effectiveness of micopulse laser in the treatment of diabetic macular oedema.
This was a non-comparative case series. 36 eyes of 23 patients received micropulse laser for clinically significant macular oedema. A 810nm laser was used for all treatments (Iridex, Mountainview, CA) The settings used for macular treatment were 100 μm x 950 miliwatts x 5% duty cycle x 300 milliseconds. the laser was applied in a dense contiguous pattern over the edematous area based on OCT. An indirect Area Centralis (Volk Optical, Mentor, OH) contact lens was used for all treatments. Parameters measured included visual acuity, central macular thickness, central 1 mm OCT volume, central 6 mm OCT volume, fundus autofluorescence. Patients received treatment on an "as required" basis at regular review.
Mean Visual acuity improved from 0.78 to 0.84 after laser. Mean central 1mm and 6mm OCT volume remained stable following treatment. Central 1mm volume was 0.231mm3 before and 0.238mm3 after laser treatment. Mean central 6mm OCT volume was 7.975mm3 before and 7.965mm3 after laser. Central macula thickness remained stable at 296μm before and 298μm after laser. There was no evidence of RPE damage seen on fundus auotfluorescence.
Tissue sparing micropulse laser has a beneficial long-term effect on maintenance of visual acuity and resolution of diabetic macula oedema. The treatment was associated with no chorioretinal damage.
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