Título / Title

PASCAL PHOTOREPARATION RELATING SHORT PULSE DURATION AND SUBTHRESHOLD ENDPOINT MANAGEMENT FOR DIABETIC MACULAR EDEMA: THE “SANDWICH” TECHNIQUE

Introdução / Purpose

To evaluate the effect of combined sublethal laser modalities, the Sandwiched technique (SWiT), to reduce retinal thickness in diabetic macular edema (DME) spectrum course. Our goal is associate refined laser methods to optimize potential alternative tool for recurrent, persistent or even as a combined therapy option an untreated macular edema.

Material e Método / Methods

This study was conducted in eyes with DME in real-life conditions. Consecutive retrospective analysis of central subfield foveal thickness (CSFT) on spectralis B-scan ocular coherence tomography (SB-OCT) and best corrected visual acuity (BCVA) were studied previously and later to SWiT-laser therapy. Thirty-seven miscellaneous cases were treated with photo thermal stimulation using 532-nm green diode laser by SWiT, which associated short-pulse duration (SPD) and subthreshold endpoint management (EpM) on Pascal® (pattern scanning laser) device.

Resultados / Results

Most of 37 cases had an improvement in CSFT, BCVA and leakage on fluorescein angiography following treatment. At baseline, mean CSFT (µm) ± standard error (SE) and BCVA (log-MAR) ± SE was 456.95 ± 37.00 and 0.71 ± 0.29 respectively. After mean follow-up of 19.2 months, mean CSFT (µm) ± SE and BCVA (log-MAR) ± SE were 272.09 ± 9.10 (p < 0.0001) and 0.54 ± 0.26 (p = 0.003). A statistically significant reduction on CSFT (µm) and BCVA (log-MAR) was noted compared to baseline. A decreased mean number of anti-VEGF injections were required after combined treatment.

Discussão e Conclusões / Conclusion

The novel SWiT laser therapy is a technique that offers clear advantage of minimizing or avoiding large laser-induced visible retinal burn/scarring while reducing the foveal thickness in the management of selected cases of DME. This Photo thermal stimulation appears safe and effective in the short term and may have significant long-term advantages on DME managing.

Palavras Chave

Subthreshold laser, Diabetic macular edema