Título

STANDARD-DENSITY VERSUS HIGH-DENSITY MICROPULSE LASER THERAPY ASSOCIATED TO RANIBIZUMAB FOR DIABETIC MACULAR EDEMA TREATMENT – PRELIMINARY RESULTS

Introdução / Purpose

Macular edema occurs in approximately one third of patients with diabetic retinopathy with disease duration greater than 20 years, and is the main cause of reduced visual acuity in the early stage of the disease. There are multiple treatment modalities for diabetic macular edema (DME). The aim of the present study was to compare the association of two modalities of micropulse laser with intravitreal anti-VEGF for the treatment of DME. The standard density (SD) was the one sufficient to treat the entire posterior pole area using a 125µm-spot and consisted of 800 shots, while the high-density (HD) micropulse was established as the spots necessary to cover the same area twice (1600 shots)

Material e Método / Methods

Prospective study, which included patients with DME and CMT>300µm. Patients were randomized into 2 groups: Group A: SD-micropulse (700-800 shots) and intra-vitreous injection of 0.5 mg of ranibizumab (IVR) and Group B: HD-micropulse (1500-1600 shots) plus IVR. Comprehensive Ophthalmic evaluation was performed at Baseline and included BCVA, fluorescein angiograpghy and SD-OCT. Patients were then evaluated monthly. These evaluations included fundus pictures and SD-OCT. Micropulse LASER could be repeated monthly and LASER quarterly if CMT>300µm.

Resultados / Results

A total of 20 eyes completed the 28-week study visit, 12 in the SD-micropulse group and 8 in the HD-micropulse group. There was no difference in baseline BCVA and CSFT between the two groups.There was an improvement in the BCVA and a decrease in CMT in both groups, with a trend towards more significant improvement in the BCVA in the group that received high-density micropulse LASER than in the group that received ND-micropulse (p= 0.056). However, mean CSFT reduction was similar in both groups (p= 0.829). There was no cases of elevated intraocular pressure or lens opacity increase.

Discussão e Conclusões / Discussion

The present study demonstrates a trend of superior visual benefit in performing HD-micropulse when compared to SD-density,when associated with anti-VEGF therapy.

Palavras Chave

Diabetic macular edema, micropulse laser, anti-VEGF therapy