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