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Macular laser photocoagulation guided by spectral-domain optical coherence tomography versus fluorescein angiography for diabetic macular edema.

Gallego-Pinazo R, Suelves-Cogollos AM, Dolz-Marco R, Arevalo JF, García-Delpech S, Mullor JL, Díaz-Llopis M - Clin Ophthalmol (2011)

Bottom Line: Subjects treated using FA-guided laser improved BCVA from the logarithm of the minimum angle of resolution (logMAR) 0.52 ± 0.2 to 0.37 ± 0.2 (P < 0.001), and decreased mean central macular thickness from 397.25 ± 139.1 to 333.50 ± 105.7 μm (P < 0.001) and retinal volume from 12.61 ± 1.6 to 10.94 ± 1.4 mm(3) (P < 0.001).Subjects treated using SD-OCT guided laser had improved BCVA from 0.48 ± 0.2 to 0.33 ± 0.2 logMAR (P < 0.001), and decreased mean central macular thickness from 425.90 ± 149.6 to 353.4 ± 140 μm (P < 0.001) and retinal volume from 12.38 ± 2.1 to 11.53 ± 1.1 mm(3) (P < 0.001).No significant differences between the groups were found in two-month BCVA (P = 0.505), two-month central macular thickness (P = 0.660), or two-month retinal volume (P = 0.582).

View Article: PubMed Central - PubMed

Affiliation: Department of Ophthalmology, Hospital Universitario La Fe, Valencia, Spain;

ABSTRACT

Background: The aim of this study was to compare the efficacy of spectral-domain optical coherence tomography (SD-OCT) and fluorescein angiography (FA) in the guidance of macular laser photocoagulation for diabetic macular edema.

Methods: This was a prospective interventional clinical comparative pilot study. Forty eyes from 24 consecutive patients with diabetic macular edema were allocated to receive laser photocoagulation guided by SD-OCT or FA. Best-corrected visual acuity (BCVA), central macular thickness, and retinal volume were assessed at baseline and two months after treatment.

Results: Subjects treated using FA-guided laser improved BCVA from the logarithm of the minimum angle of resolution (logMAR) 0.52 ± 0.2 to 0.37 ± 0.2 (P < 0.001), and decreased mean central macular thickness from 397.25 ± 139.1 to 333.50 ± 105.7 μm (P < 0.001) and retinal volume from 12.61 ± 1.6 to 10.94 ± 1.4 mm(3) (P < 0.001). Subjects treated using SD-OCT guided laser had improved BCVA from 0.48 ± 0.2 to 0.33 ± 0.2 logMAR (P < 0.001), and decreased mean central macular thickness from 425.90 ± 149.6 to 353.4 ± 140 μm (P < 0.001) and retinal volume from 12.38 ± 2.1 to 11.53 ± 1.1 mm(3) (P < 0.001). No significant differences between the groups were found in two-month BCVA (P = 0.505), two-month central macular thickness (P = 0.660), or two-month retinal volume (P = 0.582).

Conclusion: The short-term results of this pilot study suggest that SD-OCT is a safe and effective technique and could be considered as a valid alternative to FA in the guidance of macular laser photocoagulation treatment for diabetic macular edema.

No MeSH data available.


Related in: MedlinePlus

Example of fluorescein angiography guidance of macular laser photocoagulation (A) showing the leaking area of the macula (surrounded by arrowheads). The equivalent color fundus photograph (B) is used to show the laser spot location mapping (blue asterisks).
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f1-opth-5-613: Example of fluorescein angiography guidance of macular laser photocoagulation (A) showing the leaking area of the macula (surrounded by arrowheads). The equivalent color fundus photograph (B) is used to show the laser spot location mapping (blue asterisks).

Mentions: As soon as the diagnosis was confirmed by OCT and FA, all patients were treated with macular photocoagulation. Eyes were selected to receive laser with argon following the ETDRS guidelines guided by FA or OCT in a 1:1 ratio. Whereas in FA-guided photocoagulation the laser spots were placed within the leaking areas showed in the angiogram (Figure 1), the laser spots in OCT-guided photocoagulation were placed within the thickened areas provided by the retinal thickness map obtained with the macular cube 512 × 128 acquisition protocol for the HD-OCT Cirrus® (Figure 2). All laser treatments were done by the same clinician (RGP), who was provided only OCT or FA (depending on the group studied) in order to guide the therapy.


Macular laser photocoagulation guided by spectral-domain optical coherence tomography versus fluorescein angiography for diabetic macular edema.

Gallego-Pinazo R, Suelves-Cogollos AM, Dolz-Marco R, Arevalo JF, García-Delpech S, Mullor JL, Díaz-Llopis M - Clin Ophthalmol (2011)

Example of fluorescein angiography guidance of macular laser photocoagulation (A) showing the leaking area of the macula (surrounded by arrowheads). The equivalent color fundus photograph (B) is used to show the laser spot location mapping (blue asterisks).
© Copyright Policy
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC3102594&req=5

f1-opth-5-613: Example of fluorescein angiography guidance of macular laser photocoagulation (A) showing the leaking area of the macula (surrounded by arrowheads). The equivalent color fundus photograph (B) is used to show the laser spot location mapping (blue asterisks).
Mentions: As soon as the diagnosis was confirmed by OCT and FA, all patients were treated with macular photocoagulation. Eyes were selected to receive laser with argon following the ETDRS guidelines guided by FA or OCT in a 1:1 ratio. Whereas in FA-guided photocoagulation the laser spots were placed within the leaking areas showed in the angiogram (Figure 1), the laser spots in OCT-guided photocoagulation were placed within the thickened areas provided by the retinal thickness map obtained with the macular cube 512 × 128 acquisition protocol for the HD-OCT Cirrus® (Figure 2). All laser treatments were done by the same clinician (RGP), who was provided only OCT or FA (depending on the group studied) in order to guide the therapy.

Bottom Line: Subjects treated using FA-guided laser improved BCVA from the logarithm of the minimum angle of resolution (logMAR) 0.52 ± 0.2 to 0.37 ± 0.2 (P < 0.001), and decreased mean central macular thickness from 397.25 ± 139.1 to 333.50 ± 105.7 μm (P < 0.001) and retinal volume from 12.61 ± 1.6 to 10.94 ± 1.4 mm(3) (P < 0.001).Subjects treated using SD-OCT guided laser had improved BCVA from 0.48 ± 0.2 to 0.33 ± 0.2 logMAR (P < 0.001), and decreased mean central macular thickness from 425.90 ± 149.6 to 353.4 ± 140 μm (P < 0.001) and retinal volume from 12.38 ± 2.1 to 11.53 ± 1.1 mm(3) (P < 0.001).No significant differences between the groups were found in two-month BCVA (P = 0.505), two-month central macular thickness (P = 0.660), or two-month retinal volume (P = 0.582).

View Article: PubMed Central - PubMed

Affiliation: Department of Ophthalmology, Hospital Universitario La Fe, Valencia, Spain;

ABSTRACT

Background: The aim of this study was to compare the efficacy of spectral-domain optical coherence tomography (SD-OCT) and fluorescein angiography (FA) in the guidance of macular laser photocoagulation for diabetic macular edema.

Methods: This was a prospective interventional clinical comparative pilot study. Forty eyes from 24 consecutive patients with diabetic macular edema were allocated to receive laser photocoagulation guided by SD-OCT or FA. Best-corrected visual acuity (BCVA), central macular thickness, and retinal volume were assessed at baseline and two months after treatment.

Results: Subjects treated using FA-guided laser improved BCVA from the logarithm of the minimum angle of resolution (logMAR) 0.52 ± 0.2 to 0.37 ± 0.2 (P < 0.001), and decreased mean central macular thickness from 397.25 ± 139.1 to 333.50 ± 105.7 μm (P < 0.001) and retinal volume from 12.61 ± 1.6 to 10.94 ± 1.4 mm(3) (P < 0.001). Subjects treated using SD-OCT guided laser had improved BCVA from 0.48 ± 0.2 to 0.33 ± 0.2 logMAR (P < 0.001), and decreased mean central macular thickness from 425.90 ± 149.6 to 353.4 ± 140 μm (P < 0.001) and retinal volume from 12.38 ± 2.1 to 11.53 ± 1.1 mm(3) (P < 0.001). No significant differences between the groups were found in two-month BCVA (P = 0.505), two-month central macular thickness (P = 0.660), or two-month retinal volume (P = 0.582).

Conclusion: The short-term results of this pilot study suggest that SD-OCT is a safe and effective technique and could be considered as a valid alternative to FA in the guidance of macular laser photocoagulation treatment for diabetic macular edema.

No MeSH data available.


Related in: MedlinePlus