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Joo Youn Shin, Oh Woong Kwon, Suk Ho Byeon; Optical Coherence Tomography - guided Selective Focal Laser Photocoagulation: A Novel Protocol for Diabetic Macular Edema. Invest. Ophthalmol. Vis. Sci. 2014;55(13):1787.
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© ARVO (1962-2015); The Authors (2016-present)
To introduce optical coherence tomography (OCT)-guided selective focal laser photocoagulation (OCT-laser) as an alternative to modified Early Treatment Diabetic Retinopathy Study (mETDRS) laser treatment for diabetic macular edema (DME).
We analyzed outcomes in 47 consecutive eyes treated with OCT- laser compared to matched 31 eyes treated with mETDRS. Best-corrected visual acuity (BCVA) and retinal thickness(central subfield thickness, maximum retinal thickness,) by OCT were compared at baseline and 12 months after treatment between OCT-laser and mETDRS treatment groups. Degree of retinal damage by fundus autofluorescence and OCT imaging were also compared.
OCT-laser treatment resulted in significant improvements in BCVA and retinal thickness from baseline at 12 months from the time of therapy (change from baseline: +2.5 letter score, p=0.04; -45.56 μm in CST, p<0.001; -91.6 μm in MRT,p<0.001). There were also no differences in changes of these parameters from baseline at 12 months between two groups (p=0.56, p=0.89, p=0.43, respectively). Fundus autofluorescence (FAF) and OCT revealed minimal tissue damage in OCT-laser-treated eyes, compared to eyes treated with mETDRS(p<0.001).
OCT-laser is a safe and effective treatment for DME. In an era of anti-VEGF therapy, this novel laser technique may be a promising adjuvant modality for the treatment of DME.
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