Importance of 3-D image reconstruction of spectral-domain OCT on outcome of grid laser photocoagulation for diffuse diabetic macular edema
<b>AIM:</b>To present the outcome of modified grid laser photocoagulation (GLP) in diffuse diabetic macular edema (DDME) in eyes without extrafoveal and/or vitreofoveal traction. <b>METHODS:</b>Inclusion criteria for the retrospective study were DDME eyes of patien...
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| Format: | Article |
| Language: | English |
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Press of International Journal of Ophthalmology (IJO PRESS)
2013-12-01
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| Series: | International Journal of Ophthalmology |
| Subjects: | |
| Online Access: | http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3874525/ |
| _version_ | 1818135273559556096 |
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| author | Avinoam Ophir Rana Hanna Michael R. Martinez |
| author_facet | Avinoam Ophir Rana Hanna Michael R. Martinez |
| author_sort | Avinoam Ophir |
| collection | DOAJ |
| description | <b>AIM:</b>To present the outcome of modified grid laser photocoagulation (GLP) in diffuse diabetic macular edema (DDME) in eyes without extrafoveal and/or vitreofoveal traction.
<b>METHODS:</b>Inclusion criteria for the retrospective study were DDME eyes of patients with type II diabetes mellitus that had ≥4 months of follow-up following GLP. Only one eye per patient was analyzed. Using 3-D spectral-domain optical coherence tomography (3-D SD-OCT), eyes that had either extrafoveal or vitreofoveal traction, or had been previously treated by an intravitreal medication(s) were excluded. Treated DDME eyes were divided into 4 groups:A) “Classic” DDME that involved the central macula; B) edema did not involve the macular center; C) eyes associated with central epiretinal membrane (ERM); D) DDME that was associated with macular capillary dropout ≥2 disc-diameter (DD).
<b>RESULTS:</b>GLP outcome in 35 DDME eyes after 4-24 (mean, 13.1±6.9) months was as follows:Group A) 18 eyes with “classic” DDME. Following one or 2 (mean, 1.2) GLP treatments, best-corrected visual acuity (BCVA) improved by 1-2 Snellen lines in 44.4% (8/18) of eyes, and worsened by 1 line in 11.1% (2/18). Central macular thickness (CMT) improved by 7%-49% (mean, 26.6%) in 77.8% (14/18) of eyes. Causes of CMT worsening (<i>n</i>=4) were commonly explainable, predominantly (<i>n</i>=3) associated with emergence of extrafoveal traction, 5-9 months post-GLP. Group B) GLP(s) in DDME that did not involve the macular center (<i>n</i>=6) resulted in improved BCVA by 1-2 lines in 2 eyes. However, the central macula became involved in the edema process after the GLP in 3 (50%) eyes, associated with an emergence of extrafoveal traction in one of these eyes 4 months following the GLP. Group C) GLP failed in all 5 eyes associated with central ERM. Group D) GLP was of partial benefit in 2 of 6 treated eyes with macular capillary dropout ≥2DD.
<b>CONCLUSION:</b>Eyes with DDME that involved the macular center were found to achieve favourable outcomes after GLP(s) during mid-term follow-up, unless complicated pre-GLP or post-GLP by vitreoretinal interface abnormalities, often extrafoveal traction or ERM, or by capillary dropout ≥2DD. Prospective studies with larger cohorts are required. |
| first_indexed | 2024-12-11T09:21:54Z |
| format | Article |
| id | doaj.art-d72118d1c0dd46b78c26b9a8ad9364a8 |
| institution | Directory Open Access Journal |
| issn | 2222-3959 2227-4898 |
| language | English |
| last_indexed | 2024-12-11T09:21:54Z |
| publishDate | 2013-12-01 |
| publisher | Press of International Journal of Ophthalmology (IJO PRESS) |
| record_format | Article |
| series | International Journal of Ophthalmology |
| spelling | doaj.art-d72118d1c0dd46b78c26b9a8ad9364a82022-12-22T01:13:15ZengPress of International Journal of Ophthalmology (IJO PRESS)International Journal of Ophthalmology2222-39592227-48982013-12-016683684310.3980/j.issn.2222-3959.2013.06.17Importance of 3-D image reconstruction of spectral-domain OCT on outcome of grid laser photocoagulation for diffuse diabetic macular edemaAvinoam Ophir0Rana Hanna1Michael R. Martinez2Division of Ophthalmology, Hillel-Yaffe Medical Center, Hadera 31800, Israel;<br>The Ruth and Bruce Rappaport Faculty of Medicine, the Technion, Haifa 3200003, IsraelDivision of Ophthalmology, Hillel-Yaffe Medical Center, Hadera 31800, Israel<br>Division of Ophthalmology, Hillel-Yaffe Medical Center, Hadera 31800, Israel<br><b>AIM:</b>To present the outcome of modified grid laser photocoagulation (GLP) in diffuse diabetic macular edema (DDME) in eyes without extrafoveal and/or vitreofoveal traction. <b>METHODS:</b>Inclusion criteria for the retrospective study were DDME eyes of patients with type II diabetes mellitus that had ≥4 months of follow-up following GLP. Only one eye per patient was analyzed. Using 3-D spectral-domain optical coherence tomography (3-D SD-OCT), eyes that had either extrafoveal or vitreofoveal traction, or had been previously treated by an intravitreal medication(s) were excluded. Treated DDME eyes were divided into 4 groups:A) “Classic” DDME that involved the central macula; B) edema did not involve the macular center; C) eyes associated with central epiretinal membrane (ERM); D) DDME that was associated with macular capillary dropout ≥2 disc-diameter (DD). <b>RESULTS:</b>GLP outcome in 35 DDME eyes after 4-24 (mean, 13.1±6.9) months was as follows:Group A) 18 eyes with “classic” DDME. Following one or 2 (mean, 1.2) GLP treatments, best-corrected visual acuity (BCVA) improved by 1-2 Snellen lines in 44.4% (8/18) of eyes, and worsened by 1 line in 11.1% (2/18). Central macular thickness (CMT) improved by 7%-49% (mean, 26.6%) in 77.8% (14/18) of eyes. Causes of CMT worsening (<i>n</i>=4) were commonly explainable, predominantly (<i>n</i>=3) associated with emergence of extrafoveal traction, 5-9 months post-GLP. Group B) GLP(s) in DDME that did not involve the macular center (<i>n</i>=6) resulted in improved BCVA by 1-2 lines in 2 eyes. However, the central macula became involved in the edema process after the GLP in 3 (50%) eyes, associated with an emergence of extrafoveal traction in one of these eyes 4 months following the GLP. Group C) GLP failed in all 5 eyes associated with central ERM. Group D) GLP was of partial benefit in 2 of 6 treated eyes with macular capillary dropout ≥2DD. <b>CONCLUSION:</b>Eyes with DDME that involved the macular center were found to achieve favourable outcomes after GLP(s) during mid-term follow-up, unless complicated pre-GLP or post-GLP by vitreoretinal interface abnormalities, often extrafoveal traction or ERM, or by capillary dropout ≥2DD. Prospective studies with larger cohorts are required.http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3874525/extrafoveal tractionvitreofoveal tractiongrid lasermacular edemanon-center-involved macular edemaepiretinal membraneEvi membranemacular capillary dropout3-D spectral-domain optical coherence tomography3-D spectral-domain optical coherence tomography |
| spellingShingle | Avinoam Ophir Rana Hanna Michael R. Martinez Importance of 3-D image reconstruction of spectral-domain OCT on outcome of grid laser photocoagulation for diffuse diabetic macular edema International Journal of Ophthalmology extrafoveal traction vitreofoveal traction grid laser macular edema non-center-involved macular edema epiretinal membrane Evi membrane macular capillary dropout 3-D spectral-domain optical coherence tomography 3-D spectral-domain optical coherence tomography |
| title | Importance of 3-D image reconstruction of spectral-domain OCT on outcome of grid laser photocoagulation for diffuse diabetic macular edema |
| title_full | Importance of 3-D image reconstruction of spectral-domain OCT on outcome of grid laser photocoagulation for diffuse diabetic macular edema |
| title_fullStr | Importance of 3-D image reconstruction of spectral-domain OCT on outcome of grid laser photocoagulation for diffuse diabetic macular edema |
| title_full_unstemmed | Importance of 3-D image reconstruction of spectral-domain OCT on outcome of grid laser photocoagulation for diffuse diabetic macular edema |
| title_short | Importance of 3-D image reconstruction of spectral-domain OCT on outcome of grid laser photocoagulation for diffuse diabetic macular edema |
| title_sort | importance of 3 d image reconstruction of spectral domain oct on outcome of grid laser photocoagulation for diffuse diabetic macular edema |
| topic | extrafoveal traction vitreofoveal traction grid laser macular edema non-center-involved macular edema epiretinal membrane Evi membrane macular capillary dropout 3-D spectral-domain optical coherence tomography 3-D spectral-domain optical coherence tomography |
| url | http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3874525/ |
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