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Renato Peroni, Jose A. Cardillo, Alessandro J. Dare, Joao Guilherme Aguirre, Daniel Lavinsky, Michel E. Farah, Rubens Belfort, Jr.; A Combined Low Energy, Short Pulsed 577 nm Mild Macular Grid Photocoagulation with 577 nm-Micropulsed Central Laser Stimulation for Diabetic Macular Edema with Foveal Leakage (The Sandwich Grid). Invest. Ophthalmol. Vis. Sci. 2011;52(14):590.
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© ARVO (1962-2015); The Authors (2016-present)
To determine the anatomical and functional outcome of combined barely visible 577nm photocoagulation lesions placed throughout the macula and microaneurysms area with a 577 nm-micropulsed central photo stimulation in patients with diabetic macular edema (DME) with foveal leakage.
Twenty-eight eyes of 25 patients with DME were treated using a yellow diode laser (577 nm) clinically adjusted to show barely visible photocoagulation lesions at 10 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 fluorecein angiography (FA) were performed before, 1, 3 and 6 months after a single treatment.
Central macular thickness decreased by an average of 201µm. At 6 months main change in visual acuity was 3 letters better. Mean macular sensitivity improved (P<0.005) at 3 and 6 months. Laser lesions were not clinically observed, but detected on FA examination. The foveal area no signs of treatment could be observed by any means.
In the effort to minimize the side effects while maintaining the efficacy, combination of mild macular grid and foveal micropulse may characterize a more selective alternative to progress macular photocoagulation for DME with central foveal leakage.
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