Abstract
Purpose :
To evaluate the efficacy and safety of subthreshold laser grid photocoagulation (SLGP) in patients affected by diabetic macular edema (DME).
Methods :
For the past decades, laser photocoagulation has been the mainstay of treatment for patients with DME; however, although effective in preserving vision, this form of therapy is of limited effect in restoring lost vision. Recently, anti vascular endothelial growth factor agents and corticosteroids have been approved for the treatment of DME but there are still some questions regarding safety, dose frequency and costs for both the patients and the national health system. Retrospective analysis of the I-maculaweb database selecting patients with DME treated with SLGP. The patients for this study were selected according to the following characteristics: not being able to receive either anti-VEGF agents, due to medical reasons, or corticosteroids being phakic or cortisone responders or among those who did not show any improvement after anti-VEGF injections. 21 eyes of 14 caucasian patients were treated with SLGP using 10 ms, 100 µm single spot, 50% end point management. Initial energy was 100 mW, increases of 25 mW were utilised as needed.
Patients were retreated after a minimum time of 3 months when either the central retinal thickness (CRT) didn’t show any sign of decrease or best corrected visual acuity (BCVA) didn’t increase more than 5 letter. Mean number of SLGP was 1.4±0.75.
Glycosilated Haemoglobin levels were monitored before the treatment and did not differ significantly during the follow-up.
Results :
Mean age was 68 years±16.85. Mean CRT at baseline and last follow-up visit was 327.49µ ±27.40 and 312.07 µ ±32.06 respectively (p=0.0045; paired t test). Mean number of ETDRS letter score at baseline and last follow-up visit was 67.43±9.93 and 71.38±10.95 (p=0,0075; paired t test) respectively. Mean follow-up was 11.52 months ±9.02.
No visual and systemic adverse events were experienced after the SLGP.
Conclusions :
SLGP might be a safe and useful option in those patients who cannot receive either anti-vegf agents or corticosteroids.
This is an abstract that was submitted for the 2016 ARVO Annual Meeting, held in Seattle, Wash., May 1-5, 2016.