The efficacy of selective retina therapy for diabetic macular edema based on pretreatment central foveal thickness

Lasers Med Sci. 2020 Oct;35(8):1781-1790. doi: 10.1007/s10103-020-02984-6. Epub 2020 Feb 24.

Abstract

To evaluate the efficacy of selective retina therapy (SRT) in patients with diabetic macular edema (DME) based on pretreatment central foveal thickness (CFT). Seventy-two eyes of 63 patients with DME who had previously undergone SRT were included. Patients were divided into two groups based on the CFT at baseline. Group 1 was composed of 35 eyes with CFT < 400 μm and group 2 was composed of 37 eyes with CFT ≥ 400 μm. Changes in best corrected visual acuity (BCVA) and CFT were measured at baseline, 3 and 6 months after SRT. A single-session retreatment was performed at 3-month posttreatment if there was no reduction in CFT. Rescue treatment with intravitreal anti-VEGF injections was performed if persistent DME or vision loss of 1 ≥ logMAR VA line was observed by 6 months after initial SRT. Six months after SRT, group 1 showed reduction of 45.9 μm in mean CFT (P < 0.001) and gain of 0.13 logMAR in mean BCVA (P < 0.001), whereas group 2 experienced no significant change in CFT or BCVA. In group 1, retreatments were performed in 6 eyes (17.1%), and rescue treatment was performed in 1 eye (2.9%), whereas in group 2, retreatment was performed in 17 eyes (45.9%), and rescue treatments were administered in 27 eyes (73%) during a 6-month follow-up. Although SRT had limited effects as a treatment for severe DME, SRT monotherapy for mild DME was effective in improving BCVA and reducing CFT during a 6-month follow-up period.

Keywords: Central foveal thickness; Diabetic macular edema; Retinal pigment epithelium; Selective retina therapy; Subthreshold micropulse laser.

MeSH terms

  • Aged
  • Bevacizumab / pharmacology
  • Bevacizumab / therapeutic use
  • Diabetic Retinopathy / diagnostic imaging
  • Diabetic Retinopathy / drug therapy*
  • Diabetic Retinopathy / pathology*
  • Diabetic Retinopathy / physiopathology
  • Female
  • Humans
  • Macular Edema / diagnostic imaging
  • Macular Edema / drug therapy*
  • Macular Edema / pathology*
  • Macular Edema / physiopathology
  • Male
  • Middle Aged
  • Retina / drug effects*
  • Retina / pathology*
  • Retina / physiopathology
  • Retreatment
  • Tomography, Optical Coherence
  • Treatment Outcome
  • Visual Acuity

Substances

  • Bevacizumab