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When and how to do a grid laser for diabetic macular edema
F Bandello1, P Lanzetta, U Menchini
1Department of Ophthalmology, University of Udine, Italy.
Documenta Ophthalmologica. Advances in Ophthalmology
|July 15, 2000
Summary
Grid laser treatment effectively reduces macular edema by targeting abnormal retinal vessel permeability. This procedure uses specific laser wavelengths to improve the blood-retinal barrier function, offering a potential therapeutic option for posterior segment diseases.
Area of Science:
- Ophthalmology
- Retinal Diseases
- Laser Therapy
Background:
- Macular edema involves abnormal permeability of the inner (retinal vessels) and outer (retinal pigment epithelium) blood-retinal barriers.
- It manifests as diffuse thickening or cystoid changes in the macula.
- This condition is a common feature of various posterior segment diseases.
Purpose of the Study:
- To evaluate the efficacy of grid laser treatment for macular edema.
- To explore the potential mechanisms behind the therapeutic effects of grid laser treatment.
Main Methods:
- Grid laser application involves applying spots (100-250 micrometers) to the posterior pole, sparing the foveal avascular zone.
- Treatment areas temporal and nasal to the macula are spared in bilateral cases to prevent scotomas.
- Long-wavelength lasers (krypton red, diode) are recommended.
Main Results:
- Grid laser treatment may reduce macular edema.
- The exact mechanism of action is debated, with hypotheses including pigment epithelial cell proliferation, improved outer blood-retinal barrier function, and release of beneficial factors.
- Potential improvement of inner blood-retinal barrier function and retinochoroidal exchanges are also considered.
Conclusions:
- Grid laser treatment is a potential therapeutic option for macular edema.
- Further research is needed to fully elucidate the mechanisms of action.
- Optimizing laser parameters and treatment areas is crucial for efficacy and safety.