Microperimetric analysis of diabetic macular edema after navigated direct photocoagulation with short-pulse laser for microaneurysms
Abstract Background Focal laser photocoagulation is an important treatment option for diabetic macular edema (DME). This study aimed to examine the retinal sensitivity (RS) and morphological changes at the coagulated site after direct photocoagulation of microaneurysms (MAs) in patients with DME usi...
| Main Authors: | , , , , , , , , |
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| Format: | Article |
| Language: | English |
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BMC
2023-03-01
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| Series: | International Journal of Retina and Vitreous |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s40942-023-00447-y |
| _version_ | 1797863941113643008 |
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| author | Yasuko Ikegami Tomoyasu Shiraya Fumiyuki Araki Takashi Ueta Taku Toyama Tomohiko Yanagita Jiro Numaga Nobuyuki Shoji Satoshi Kato |
| author_facet | Yasuko Ikegami Tomoyasu Shiraya Fumiyuki Araki Takashi Ueta Taku Toyama Tomohiko Yanagita Jiro Numaga Nobuyuki Shoji Satoshi Kato |
| author_sort | Yasuko Ikegami |
| collection | DOAJ |
| description | Abstract Background Focal laser photocoagulation is an important treatment option for diabetic macular edema (DME). This study aimed to examine the retinal sensitivity (RS) and morphological changes at the coagulated site after direct photocoagulation of microaneurysms (MAs) in patients with DME using a navigated laser photocoagulator with a short-pulse duration of 30 ms. Methods Images of early-phase fluorescein angiography were merged with images from the optical coherence tomography (OCT) map with 9 Early Treatment Diabetic Retinopathy Study grid circles, and MAs inside the edema area were selected for direct photocoagulation. The best-corrected visual acuity (BCVA), parameters of the OCT map including central retinal thickness and retinal thickness in edema range, central RS, and RS in the edema area were assessed at 1 and 3 months after the laser treatment. The RS points that overlapped with the laser spots were identified by merging the Navilas’ digital treatment reports and the microperimetry images. Results Seventeen eyes from 14 patients were studied. The mean retinal thickness in the edema range decreased at 3 months compared with pretreatment (P = 0.042), but the BCVA, central retinal thickness, central RS, and RS in the edema area remained unchanged. Overall, 32 of 400 sensitivity points overlapped with the laser-coagulated spots. The mean RS at these spots were 22.4 ± 5.3 dB at 1 month and 22.5 ± 4.8 dB at 3 months, with no significant change from the baseline of 22.7 ± 3.5 dB. Conclusions Retinal thickness improved in the coagulated edema area without a decrease in RS after direct photocoagulation of MAs with a short 30-ms pulse using Navilas. This promising therapeutic strategy for DME is effective and minimally invasive. |
| first_indexed | 2024-04-09T22:43:43Z |
| format | Article |
| id | doaj.art-550d471751f948bab88066bbf34bd407 |
| institution | Directory Open Access Journal |
| issn | 2056-9920 |
| language | English |
| last_indexed | 2024-04-09T22:43:43Z |
| publishDate | 2023-03-01 |
| publisher | BMC |
| record_format | Article |
| series | International Journal of Retina and Vitreous |
| spelling | doaj.art-550d471751f948bab88066bbf34bd4072023-03-22T12:00:08ZengBMCInternational Journal of Retina and Vitreous2056-99202023-03-01911710.1186/s40942-023-00447-yMicroperimetric analysis of diabetic macular edema after navigated direct photocoagulation with short-pulse laser for microaneurysmsYasuko Ikegami0Tomoyasu Shiraya1Fumiyuki Araki2Takashi Ueta3Taku Toyama4Tomohiko Yanagita5Jiro Numaga6Nobuyuki Shoji7Satoshi Kato8Department of Ophthalmology, University of Kitasato School of MedicineDepartment of Ophthalmology, Graduate School of Medicine, University of TokyoDepartment of Ophthalmology, Graduate School of Medicine, University of TokyoDepartment of Ophthalmology, Graduate School of Medicine, University of TokyoDepartment of Ophthalmology, Graduate School of Medicine, University of TokyoDepartment of Ophthalmology, University of Kitasato School of MedicineDepartment of Ophthalmology, Tokyo Metropolitan Geriatric HospitalDepartment of Ophthalmology, University of Kitasato School of MedicineDepartment of Ophthalmology, Graduate School of Medicine, University of TokyoAbstract Background Focal laser photocoagulation is an important treatment option for diabetic macular edema (DME). This study aimed to examine the retinal sensitivity (RS) and morphological changes at the coagulated site after direct photocoagulation of microaneurysms (MAs) in patients with DME using a navigated laser photocoagulator with a short-pulse duration of 30 ms. Methods Images of early-phase fluorescein angiography were merged with images from the optical coherence tomography (OCT) map with 9 Early Treatment Diabetic Retinopathy Study grid circles, and MAs inside the edema area were selected for direct photocoagulation. The best-corrected visual acuity (BCVA), parameters of the OCT map including central retinal thickness and retinal thickness in edema range, central RS, and RS in the edema area were assessed at 1 and 3 months after the laser treatment. The RS points that overlapped with the laser spots were identified by merging the Navilas’ digital treatment reports and the microperimetry images. Results Seventeen eyes from 14 patients were studied. The mean retinal thickness in the edema range decreased at 3 months compared with pretreatment (P = 0.042), but the BCVA, central retinal thickness, central RS, and RS in the edema area remained unchanged. Overall, 32 of 400 sensitivity points overlapped with the laser-coagulated spots. The mean RS at these spots were 22.4 ± 5.3 dB at 1 month and 22.5 ± 4.8 dB at 3 months, with no significant change from the baseline of 22.7 ± 3.5 dB. Conclusions Retinal thickness improved in the coagulated edema area without a decrease in RS after direct photocoagulation of MAs with a short 30-ms pulse using Navilas. This promising therapeutic strategy for DME is effective and minimally invasive.https://doi.org/10.1186/s40942-023-00447-yDiabetic macula edemaMicroaneurysmsMicroperimetryFocal laser photocoagulationNavigated laser |
| spellingShingle | Yasuko Ikegami Tomoyasu Shiraya Fumiyuki Araki Takashi Ueta Taku Toyama Tomohiko Yanagita Jiro Numaga Nobuyuki Shoji Satoshi Kato Microperimetric analysis of diabetic macular edema after navigated direct photocoagulation with short-pulse laser for microaneurysms International Journal of Retina and Vitreous Diabetic macula edema Microaneurysms Microperimetry Focal laser photocoagulation Navigated laser |
| title | Microperimetric analysis of diabetic macular edema after navigated direct photocoagulation with short-pulse laser for microaneurysms |
| title_full | Microperimetric analysis of diabetic macular edema after navigated direct photocoagulation with short-pulse laser for microaneurysms |
| title_fullStr | Microperimetric analysis of diabetic macular edema after navigated direct photocoagulation with short-pulse laser for microaneurysms |
| title_full_unstemmed | Microperimetric analysis of diabetic macular edema after navigated direct photocoagulation with short-pulse laser for microaneurysms |
| title_short | Microperimetric analysis of diabetic macular edema after navigated direct photocoagulation with short-pulse laser for microaneurysms |
| title_sort | microperimetric analysis of diabetic macular edema after navigated direct photocoagulation with short pulse laser for microaneurysms |
| topic | Diabetic macula edema Microaneurysms Microperimetry Focal laser photocoagulation Navigated laser |
| url | https://doi.org/10.1186/s40942-023-00447-y |
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