The efficacy of selective retina therapy for diabetic macular edema based on pretreatment central foveal thickness
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ORIGINAL ARTICLE
The efficacy of selective retina therapy for diabetic macular edema based on pretreatment central foveal thickness Minhee Kim 1 & Young Gun Park 2 & Seung Hee Jeon 1 & Seung Yong Choi 1 & Young-Jung Roh 1 Received: 2 October 2019 / Accepted: 14 February 2020 # Springer-Verlag London Ltd., part of Springer Nature 2020
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
Introduction Diabetic macular edema (DME), an advanced complication of diabetic retinopathy, is the leading cause of visual loss in diabetic patients [1, 2]. The causative mechanism of DME is thought to be the abnormal permeability of retinal capillaries and fluid accumulation between 2 plexiform layers [3, 4]. If left untreated, 25–30% of affected patients will experience a 15-letter (three line) decrease in visual acuity on the Early Treatment of Diabetic Retinopathy Study (ETDRS) eye chart within 3 years [5]. The ETDRS trial showed that conventional
* Young-Jung Roh [email protected] 1
Department of Ophthalmology and Visual Science, Yeouido St. Mary’s Hospital, College of Medicine, Catholic University of Korea, 10,63-ro, Yeongdeungpo-gu, Seoul 07345, Republic of Korea
2
Department of Ophthalmology and Visual Science, Seoul St. Mary’s Hospital, College of Medicine, Catholic University of Korea, 222, Banpo-daero, Seocho-gu, Seoul 06591, Republic of Korea
laser photocoagulation (CLP) reduced the risk of severe visual loss at least 50% in patients with clinically significant DME over a 3-year period when compa
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