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Sophia Wong, Emeline Ramenaden, Rashed Alhabshan, Lindsay Smithen, Jeevan R Mathura; The efficacy and safety of 577-nm subthreshold diode micropulse photocoagulation in macular edema. Invest. Ophthalmol. Vis. Sci. 2014;55(13):6360.
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To assess the efficacy and safety of 577-nm subthreshold diode micropulse (SDM) laser in patients with macular edema by evaluating retinal thickness and autofluorescence
A retrospective chart review was conducted on all patients who were seen at a university-based retina practice between January 1, 2012 and December 31, 2012 and who had received SDM laser (IQ 577, IRIDEX Corporation, Mountain View, CA) for the treatment of macular edema. Spectral-domain optical coherence tomography (SD-OCT) (Spectralis, Heidelberg Engineering, Heidelberg, Germany), was evaluated for central mean thickness (CMT), total macular volume (TMV), and autofluorescence. Macular edema was divided into three categories of severity: mild (<350 microns), moderate (350-500 microns) and severe (>500 microns). These values were agreed upon by the investigators according to clinical experience. Patients with follow-up visits of 1, 2 or 3 months and who had not received other treatment in the interim were included.
Eighty-eight patients (104 eyes) were identified (37.5% male, 62.5% female, mean age 64.6 years). Concurrent continuous wave photocoagulation comprised 29.8% of treatments. Percent change in CMT at 1 month and 3 months was not significantly different compared to baseline. At 2 months, mean decrease in CMT was 28.34% for the severe edema group (p=0.03). Similarly, in the SDM-only severe subgroup, mean CMT decrease was 26.34% (p=0.03). The mild and moderate groups did not show a significant change in CMT from baseline. Visual acuity did not significantly change for any severity group at any time point. Comparisons using TMV in place of CMT to account for extrafoveal edema showed similar results.
Subthreshold diode micropulse photocoagulation using a 577-nm laser is effective in decreasing macular edema in patients with a high degree of baseline edema. The peak effect appears to be 2 months.
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