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Subthreshold micropulse laser reduces anti-VEGF injection burden in patients with diabetic macular edema
Elad Moisseiev1,2, Sam Abbassi1, Sumeer Thinda1
11 Department of Ophthalmology and Vision Science, University of California Davis Eye Center, Sacramento, California - USA.
Purpose:
To evaluate the efficacy of micropulse laser in the early treatment of diabetic macular edema (DME) and its associated burden of anti-vascular endothelial growth factor (VEGF) injections.
Methods:
This retrospective comparative study compared a group of 19 eyes with DME treated with micropulse laser to a matched control group of 19 eyes with DME treated with ranibizumab injections without micropulse laser. Recorded parameters included previous medical and ocular history, previous and subsequent ranibizumab injections administered for DME, visual acuity (VA), central macular thickness throughout the follow-up period, and the occurrence of any complications.
Results:
The improvement in VA was comparable in both groups, at 12 months and at the final follow-up. Patients treated with micropulse laser required significantly fewer ranibizumab injections than their controls, both at 12 months (1.7 ± 2.3 vs 5.6 ± 2.1) and by the end of the follow-up (2.6 ± 3.3 vs 9.3 ± 5.1) (p<0.001 for both). No complications related to the micropulse laser were encountered.
Conclusions:
Micropulse laser is a safe and effective treatment for DME, which may achieve comparable improvement in VA along with a significant reduction in the burden of anti-VEGF injections. We suggest a treatment approach for its inclusion in the early stages of DME.
Insights
Micropulse laser therapy offers a safe and effective early treatment for diabetic macular edema (DME), achieving comparable visual acuity improvements while significantly reducing the need for anti-vascular endothelial growth factor (VEGF) injections.
Area of Science:
- Ophthalmology
- Retinal Diseases
- Laser Therapy
Background:
- Diabetic macular edema (DME) is a leading cause of vision loss in diabetic patients.
- Current treatments often involve frequent anti-vascular endothelial growth factor (VEGF) injections, posing a significant burden.
Purpose of the Study:
- To evaluate the efficacy of early micropulse laser treatment for DME.
- To assess the impact of micropulse laser on the requirement for anti-VEGF injections.
Main Methods:
- Retrospective comparative study of 19 eyes treated with micropulse laser versus 19 control eyes treated with ranibizumab.
- Analysis of visual acuity, central macular thickness, and number of anti-VEGF injections over the follow-up period.
Main Results:
- Comparable visual acuity improvement was observed in both micropulse laser and ranibizumab groups at 12 months and final follow-up.
- Micropulse laser treatment led to a significant reduction in anti-VEGF injections compared to the control group (p<0.001).
- No complications were reported with micropulse laser treatment.
Conclusions:
- Micropulse laser is a safe and effective treatment option for early-stage DME.
- This therapy can achieve similar visual outcomes to anti-VEGF injections with fewer treatments.
- Micropulse laser warrants consideration for early DME management to reduce treatment burden.
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