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Optical coherence tomography-guided selective focal laser photocoagulation: a novel laser protocol for diabetic macular edema

 Joo Youn Shin  ;  Suk Ho Byeon  ;  Oh Woong Kwon 
 Graefes Archive for Clinical and Experimental Ophthalmology, Vol.253(4) : 527-535, 2015 
Journal Title
 Graefes Archive for Clinical and Experimental Ophthalmology 
Issue Date
BACKGROUND: To compare the anatomic and functional results between optical coherence tomography (OCT)-guided selective focal laser photocoagulation (OCT-laser) and conventional modified Early Treatment Diabetic Retinopathy Study (mETDRS) laser treatment for diabetic macular edema (DME). METHODS: We analyzed treatment outcomes in 47 consecutive eyes treated with OCT-laser compared to 31 matched eyes treated with mETDRS. In the OCT-laser group, we identified 'significant actively-leaking microaneurysms on OCT' (SALMO) which are responsible for edema in OCT B-scan images, and thoroughly ablated them with photocoagulation. Best-corrected visual acuity (BCVA) and retinal thickness by OCT were compared at baseline and 12 months after treatment between two groups. RESULTS: OCT-laser treatment resulted in significant improvements in BCVA, central subfield thickness (CST), and maximum retinal thickness (MRT) from baseline at 12 months from the time of therapy (+2.5 letter score, p = 0.04; -45.56 μm in CST, p < 0.001; -91.6 μm in MRT, p < 0.001). The mean number of treated 'SALMO' was 5.6 ± 4.0 (range 1-26), while the number of MAs in 'treatable lesions' by fluorescein angiography (FA) in the same eye was 16.3 ± 11.8 (range 2-42). There was no difference between OCT-laser and mETDRS groups in changes of these parameters from baseline at 12 months (p = 0.56, p = 0.89, p = 0.43 respectively). Fundus autofluorescence (FAF) and OCT revealed less tissue damage in OCT-laser-treated eyes, compared to eyes treated with mETDRS (p < 0.001). CONCLUSIONS: OCT-laser shows similar anatomic and functional outcomes compared to conventional laser (modified ETDRS), with significantly less retinal damages.
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1. College of Medicine (의과대학) > Dept. of Ophthalmology (안과학교실) > 1. Journal Papers
Yonsei Authors
Kwon, Oh Woong(권오웅)
Byeon, Suk Ho(변석호) ORCID logo https://orcid.org/0000-0001-8101-0830
Shin, Joo Youn(신주연)
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