01.12.2018 | Research article | Ausgabe 1/2018 Open Access

Comparison of different settings for yellow subthreshold laser treatment in diabetic macular edema
- Zeitschrift:
- BMC Ophthalmology > Ausgabe 1/2018
Background
Methods
Patient eligibility
Study design
Color fundus photograph
Fundus fluorescein angiography (FFA)
Microperimetry (MAIA ™, Centervue, Padova, Italy)
Laser photocoagulation
Study visits
Outcome measures
Statistical analysis
Results
Group A (5% DC) | Group B (15% DC) | Group C (CW) | |
---|---|---|---|
Number of eyes | 10 | 10 | 10 |
Mean duration of diabetes (years) | 6.5 ± 1.3 | 7.1 ± 1.1 | 6.3 ± 2.1 |
Mean age (years) | 58 ± 6.6 | 59 ± 6 | 57 ± 10.6 |
Lens status | Clear (5), NS1(2), NS2 (3) | Clear (5), NS1(4), NS2 (1) | Clear (4), NS1(4), NS2 (2) |
Mean BCVA (ETDRS letters) | 76 ± 10 | 80 ± 5 | 80 ± 7 |
Mean CMT (microns) | 258 ± 28 | 255 ± 58 | 248 ± 37 |
Retinal Sensitivity (dB) | 19 ± 5 | 22 ± 4 | 23 ± 4 |
Group A (5% DC) | Group B (15% DC) | Group C (CW) | |
---|---|---|---|
Number of spots applied | 435 ± 282 | 335 ± 313 | 128 ± 112 |
Fluence applied mJ/mm2 | 144.4 ± 28.8 | 167.8 ± 28.7 | 488.2 ± 142.4 |
Power range used in mW (range) | 424 ± 92.8 (220–500) | 168 ± 42.9 (130–280) | 87.3 ± 37.2 (50–180) |
Outcome measures
Parameters | CW | 5% | 15% |
---|---|---|---|
Retinal sensitivity (dB) | −2.2 ± 2.4 | + 2.4 ± 6.04(p*=0.3) | + 1.9 ± 4.1(p*=0.2) Compared to 5% (p = 0.8) |
ETDRS letters loss/gain | 0.9 ± 2.5 | −0.7 ± 7.7(p*=0.6) | 2.11 ± 2.5 (p*=0.3) Compared to 5% (p = 0.3) |
Central Retinal Thickness (microns) | 12.3 ± 41.2 | −12.4 ± 36.6 (p*=0.2) | 0.6 ± 21.3(p*=0.5) Compared to 5% (p = 0.4) |
Retinal volume (mm3) | + 0.55 ± 0.92 | −0.08 ± 0.3 (p*=0.02) | −0.12 ± 0.11 (p*=0.01) Compared to 5% (p = 0.4) |
Retinal sensitivity outcome
Visual acuity outcome
Anatomical outcome
Discussion
Wavelength (nm) | Spot size (um) | Duration (ms) | Duty Cycle | Power definition method | |
---|---|---|---|---|---|
Laursen et al. [9] | 810 | 125 | 100 | 5% | 50% of barely visible burn |
Figueira et al. [10] | 810 | 125 | 300 | 30% | 200% of barely visible burn |
Lavinsky et al. [11] | 810 | 125 | 300 | 15% | 120% of barely visible burn |
Vujosevic et al. [12] | 810 | 125 | 200 | 5% | 750 mW |
Luttrull et al. [19] | 810 | 125 | 300 | 5% | 750 mW |
Sivaprasad et al. [20] | 810 | 125 | 200 | 5% | 100% of a barely visible burn (unless more than 1200 mW in which case duty cycle was increased to 10%) |
Othman et al. [21] | 810 | 75–125 | 300 | 15% | 100% barely visible burn |
Inagaki et al. [22] | 810 | 200 | 200 | 15% | 200% barely visible burn |
Author | Spot Size | ms | DC | Power | Fluence mmJ/mm2 | Power definition method |
---|---|---|---|---|---|---|
Kwon et al. [24] | 100 | 20 | 15% | 140 | 54 | Titration in cw; starting at 100 mW upwards until barely visible burn; after switch to μp power remains immediately below test burn |
Vujosevic et al. [23] | 100 | 200 | 5% | 250 | 318 | Fixed power setting |
Yadav et al. [25] | 100 | 200 | 10% | 70–200 | 340 | Titration burn in cw, until mild retinal whitening; then μs mode and Half power |
Inagaki et al. [22] | 200 | 200 | 15% | 204 | 197 | Test burn in cw mode with 100 ms and 200 μm; then switch to 15% DC and doubling the power which is 60% of threshold energy |
Pei-pei et al. [30] | 60 | 10 | 100% | 32,4 J/cm2 | 324 | 50% of power, no switch of Pulse duration |