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Joao Guilherme M. Aguirre, Sr., Jose A. Cardillo, Alessandro J. Dare, Renato Peroni, Daniel Lavinsky, Michel E. Farah, Rubens Belfort, Jr.; 577 nm Short Pulsed and Low Energy Selective Macular Grid Laser Photocoagulation for Diffuse Diabetic Macular Edema. Invest. Ophthalmol. Vis. Sci. 2011;52(14):592.
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© ARVO (1962-2015); The Authors (2016-present)
To determine the anatomical and functional outcome of confluent (high density) and barely visible photocoagulation lesions placed 360 degrees surrounding the fovea in patients with diffuse diabetic macular edema (DME)
28 eyes of 21 patients with DME were treated using a yellow diode laser (577 nm) clinically adjusted to show barely visible photocoagulation lesions at 20 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 fluorescein angiography (FA) were performed before, 1, 3 and 6 months after a single treatment.
Central macular thickness decreased by an average of 277 µm. At 6 months main change in visual acuity was 5 letters better. Mean macular sensitivity improved (P<0.005) at 3 and 6 months. Laser lesions were not clinically observed, but detected on the early phase of the FA examination.
An extensive destruction of retinal tissue with laser burns may not be necessary to achieve an effective laser therapy. In the effort to minimize the side effects while maintaining the efficacy, short pulsed and low energy laser delivery targeting a barely visible lesion endpoint may characterize a more selective alternative to the present standard of care.
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