June 2013
Volume 54, Issue 15
Free
ARVO Annual Meeting Abstract  |   June 2013
Rescue Laser Photo Stimulation for Diabetic Macular Edema Unresponsive to Anti-VEGF Therapy
Author Affiliations & Notes
  • Jose Cardillo
    Retina Department, Universidade Federal de São Paulo, São Paulo, Brazil
    Retina Department, Universidade de São Paulo, Ribeirão Preto, Brazil
  • Alessandro Dare
    Retina Department, Centro Brasileiro de Especialidades Oftalmológicas, Araraquara, Brazil
  • Renato Peroni
    Retina Department, Hospital de Olhos de Araraquara, Araraquara, Brazil
    Retina Department, Centro Brasileiro de Especialidades Oftalmológicas, Araraquara, Brazil
  • Rodrigo Jorge
    Retina Department, Universidade de São Paulo, Ribeirão Preto, Brazil
  • Footnotes
    Commercial Relationships Jose Cardillo, None; Alessandro Dare, None; Renato Peroni, None; Rodrigo Jorge, None
  • Footnotes
    Support None
Investigative Ophthalmology & Visual Science June 2013, Vol.54, 5762. doi:https://doi.org/
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    • Get Citation

      Jose Cardillo, Alessandro Dare, Renato Peroni, Rodrigo Jorge; Rescue Laser Photo Stimulation for Diabetic Macular Edema Unresponsive to Anti-VEGF Therapy. Invest. Ophthalmol. Vis. Sci. 2013;54(15):5762. doi: https://doi.org/.

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      © ARVO (1962-2015); The Authors (2016-present)

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Abstract

Purpose: Although, ranibizumab monthly improve vision and macular edema in patients with DME, a 30 to 50% of the patients may still require adjunctive and complementary therapy. The purpose of this investigation is to evaluate the safety and efficacy of sub-lethal continuous wave laser for the treatment of diabetic macular edema (DME) unresponsive to previously anti-VEGF therapy.

Methods: Twenty patients with DME that did not presented improvement after 6 monthly injection of Ranibizumab, understood as a reduction of at least 10% of central macular thickness compared to the baseline visit and an increase of ≥ 5 letters in visual acuity, were assigned to receive rescue laser therapy. In brief, yellow diode laser (577 nm) clinically adjusted to show barely visible photocoagulation lesions at 20 ms exposure time. The mean retinal sensitivity within the central 10 degrees measured with a fundus-related microperimeter, MP1, ETDRS-best corrected visual acuity (BCVA), optical coherence tomography-determined central macular thickness (CMT), and fluorescein angiography (FA) were performed before, 1, 3 and 6 months after a single treatment.

Results: Central macular thickness decreased by an average of 198μm. At 6 months main change in visual acuity was 4 letters better. Mean macular sensitivity improved (P<0.005) at 3 and 6 months. Laser lesions were not clinically observed, but detected on the early phase of the FA examination.

Conclusions: In parallel with new pharmacologic agents for the treatment of DME, developments in new laser technologies, exploiting optimized parameters and treatment guidelines will be the key to progress DME treatment approaches for an ultimate anatomical and functional restoration

Keywords: 688 retina • 578 laser • 499 diabetic retinopathy  
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