April 2011
Volume 52, Issue 14
Free
ARVO Annual Meeting Abstract  |   April 2011
Treatment Optimization for Short Pulsed and Low Energy Delivery of Pascal Modified Macular Grid Laser Photocoagulation for Diabetic Macular Edema
Author Affiliations & Notes
  • Jose A. Cardillo
    Hospital de Olhos de Araraquara, Araraquara, SP, Brazil
    Federal University of Sao Paulo, UNIFESP, Sao Paulo, SP, Brazil
  • Alessandro J. Dare
    Retina Department, Centro Brasileiro de Especialidades Oftalmológicas (CBEO), Araraquara, SP, Brazil
  • Renato Peroni
    Retina Department, Centro Brasileiro de Especialidades Oftalmológicas (CBEO), Araraquara, SP, Brazil
  • Joao Guilherme M. Aguirre
    Retina Department, Centro Brasileiro de Especialidades Oftalmológicas (CBEO), Araraquara, SP, Brazil
  • Daniel Lavinsky
    Federal University of Sao Paulo, UNIFESP, Sao Paulo, SP, Brazil
  • Michel E. Farah
    Federal University of Sao Paulo, UNIFESP, Sao Paulo, SP, Brazil
  • Rubens Belfort, Jr.
    Federal University of Sao Paulo, UNIFESP, Sao Paulo, SP, Brazil
  • Footnotes
    Commercial Relationships  Jose A. Cardillo, None; Alessandro J. Dare, None; Renato Peroni, None; Joao Guilherme M. Aguirre, None; Daniel Lavinsky, None; Michel E. Farah, None; Rubens Belfort, Jr., None
  • Footnotes
    Support  None
Investigative Ophthalmology & Visual Science April 2011, Vol.52, 591. doi:https://doi.org/
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      Jose A. Cardillo, Alessandro J. Dare, Renato Peroni, Joao Guilherme M. Aguirre, Daniel Lavinsky, Michel E. Farah, Rubens Belfort, Jr.; Treatment Optimization for Short Pulsed and Low Energy Delivery of Pascal Modified Macular Grid Laser Photocoagulation for Diabetic Macular Edema. Invest. Ophthalmol. Vis. Sci. 2011;52(14):591. doi: https://doi.org/.

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

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Abstract

Purpose: : To compare the fix automatic pattern of Pascal modified macular grid laser photocoagulation (APD) with the same technique (same laser parameters and lesion endpoint), but manually-delivered in a high-density manner (HDD).

Methods: : 40 patients treated either with a) APD photocoagulation (20 patients) or b) HDD photocoagulation (20 patients) were retrospectively analyzed. Before treatment, and at month 1, 3 and 6 and after treatment all patients underwent standardized color fundus photography (CFP), fluorescein angiography (FA), optical coherence tomography (OCT) and ophthalmic examinations, together with standardized assessments of best-corrected visual acuity, performed by masked visual acuity assessors using ETDRS protocols. Analysis was performed by Freidman test, Kruskal-Wallis test, and Mann-Whitney test P< 0.01.

Results: : There were no statistically significant differences between the two groups regarding age, gender, race, type / duration of diabetes mellitus, HbA1c, and severity of retinopathy. At baseline, median BCVA and median CMT were not significantly different in all treatment groups. At 6 months, the HDD group had the best improvement of BCVA and the highest CMT reduction. Laser lesions were barely clinically observed, but clearly detected on FA examination. There were no adverse events and no serious collateral effects

Conclusions: : At 6 months the clinical performance favored the HDD over the APD photocoagulation technique for the anatomic and functional aspects of improvement tested in this investigation. In addition to newer treatments modalities, exploiting innovative laser technologies in parallel to a focused and engineered intervention will be the breakthrough pathway to progress DME treatment for an ultimate and sustained vision restoration.

Keywords: diabetic retinopathy • laser • retina 
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