>Cirugía y Cirujanos
>Year 2011, Issue 5
Lima-Gómez V, Razo Blanco-Hernández DM, Asbun-Bojalil J
Effect of photocoagulation on center point thickness in diabetic macular edema
Cir Cir 2011; 79 (5)
PDF: 568.74 Kb.
[Full text - PDF]
Background: Photocoagulation is the standard treatment for clinically significant macular edema (CSME). This procedure is effective in reducing macular thickening, but it has been reported that initially it does not improve the thickness at the area of best visual function (center point of the fovea). We undertook this study to compare the effect of focal photocoagulation on center point thickness (CPT) and macular volume 3 weeks after treatment in Mexican diabetic patients with CSME, with and without center point involvement.
Methods: We carried out an observational, retrospective, longitudinal, analytical, open study. Type 2 diabetic patients undergoing focal photocoagulation for CSME at a general hospital in Mexico City were evaluated. Mean CPT and macular volume were compared before and 3 weeks after photocoagulation (paired t test) in the sample and in eyes with (group 1) and without (group 2) baseline center point involvement. Absolute and percent CPT and macular volume changes were identified.
Results: Fifty nine eyes (mean age 59.6 years) were studied. CPT mean increased from 193 to 197 µm (p = 0.3), statistically in group 2 (168.8 to 178.5 µm, p ‹0.001). Macular volume mean changed from 7.8 to 7.6 mm3 (p ‹0.001). CPT increased 3.9 µm (3%) in the sample, whereas macular volume decreased 0.26 mm3 (3.1%). Correlation between changes was 0.089.
Conclusions: Although macular volume decreased statistically 3 weeks after photocoagulation, CPT did not and increased statistically in eyes without baseline center point involvement, which was unnoticed in the sample effect. These changes should not be overlooked because dealing with them could improve the early results of treatment.
||Macular edema, photocoagulation, center point thickness, optical coherence tomography, diabetic retinopathy.
Klein R, Knudtson MD, Lee KE, Gangnon R, Klein BE. The Wisconsin Epidemiologic Study of Diabetic Retinopathy XXIII: the twenty-five-year incidence of macular edema in persons with type 1 diabetes. Ophthalmology 2009;116:497-503.
Fong DS, Aiello L, Gardner TW, King GL, Blakenship G, Cavallerano JD, et al. Retinopathy in diabetes. Diabetes Care 2004;27(Suppl 1):S84-87.
Varma R, Torres M, Peña F, Klein R, Azen SP. Los Angeles Latino Eye Study Group. Prevalence of diabetic retinopathy in adult Latinos: the Los Angeles Latino eye study. Ophthalmology 2004;111:1298-1306.
Asociación Mexicana de Retina, Sociedad Mexicana de Oftalmología, Asociación Panamericana de Oftalmología. Resultados del Día Panamericano de Detección de Retinopatía Diabética (3 de julio de 1999, día D). Rev Mex Oftalmol 2005;79:88-92.
Bhagat N, Grigorian RA, Tutela A, Zarbin MA. Diabetic macular edema: pathogenesis and treatment. Surv Ophthalmol 2009;54:1-32.
American Academy of Ophthalmology. Retina Panel. Diabetic Retinopathy. Preferred practice patterns. San Francisco, CA: American Academy of Ophthalmology; 2008. p. 14.
American Academy of Ophthalmology. Retina and vitreous. Basic and Clinical Science Course. San Francisco, CA: American Academy of Ophthalmology; 2004. p. 116.
McDonald HR, Schatz H. Macular edema following panretinal photocoagulation. Retina 1985;5:5-10.
Tsujikawa A, Kiryu J, Dong J, Yasukawa T, Suzuma I, Takagi H, et al. Quantitative analysis of diabetic macular edema after scatter laser photocoagulation with the scanning retinal thickness analyzer. Retina 1999;19:59-64.
Shimura M, Yasuda K, Nakazawa T, Kano T, Ohta S, Tamai M. Quantifying alterations of macular thickness before and after panretinal photocoagulation in patients with severe diabetic retinopathy and good vision. Ophthalmology 2003;110:2386-2394.
Lee SB, Yun YJ, Kim ST, Kim JY. Changes in macular thickness after panretinal photocoagulation in patients with severe diabetic retinopathy and no macular edema. Retina 2010;20:756-760.
Campbell RJ, Coupland SG, Buhrmann RR, Kertes PJ. Optimal optical coherence tomography-based measures in the diagnosis of clinically significant macular edema: retinal volume vs foveal thickness. Arch Ophthalmol 2007;125:619-623.
Browning DJ, Glassman AR, Aiello LP, Bressler NM, Bressler SB, Danis RP, et al. Optical coherence tomography measurements and analysis methods in optical coherence tomography studies of diabetic macular edema. Ophthalmology 2008;115:1366-1371.
Polito A, Del Borrello M, Isola M, Zemella N, Bandello F. Repeatability and reproducibility of fast macular thickness mapping with stratus optical coherence tomography. Arch Ophthalmol 2005;123:1330-1337.
Sandhu SS, Birch MK, Griffiths PG, Talks SJ. Short-term effects of focal argon laser treatment in diabetic maculopathy as demonstrated by optical coherence tomography. Retina 2007;27:13-20.
Early photocoagulation for diabetic retinopathy. ETDRS report number 9. Early Treatment Diabetic Retinopathy Study Research Group. Ophthalmology 1991;98:766-785.
Sadda SR, Wu Z, Walsh AC, Richine L, Dougall J, Cortez R, et al. Errors in retinal thickness measurements obtained by optical coherence tomography. Ophthalmology 2006;113:285-293.
Lima-Gómez V, Osornio-Castro N. Comparación del grosor retiniano en diabéticos sin retinopatía, con y sin fondo coroideo. Rev Mex Oftalmol 2006;70:301-305.
Chan A, Duker JS. A standardized method for reporting changes in macular thickening using optical coherence tomography. Arch Ophthalmol 2005;123:939-943.
Krzystolik MG, Strauber SF, Aiello LP, Beck RW, Berger BB, Bressler NM, et al. Reproducibility of macular thickness and volume using Zeiss optical coherence tomography in patients with diabetic macular edema. Ophthalmology 2007;114:1520-1525.
Browning DJ, Fraser CM, Powers ME. Comparison of the magnitude and time course of macular thinning induced by different interventions for diabetic macular edema: implications for sequence of application. Ophthalmology 2006;113:1713-1719.
Brucker AJ, Qin H, Antoszyk AN, Beck RW, Bressler NM, Browning DJ, et al. Observational study of the development of diabetic macular edema following panretinal (scatter) photocoagulation given in 1 or 4 sittings. Arch Ophthalmol 2009;127:132-140.
Jennings PE, MacEwen CJ, Fallon TJ, Scott N, Haining WM, Belch JJ. Oxidative effects of laser photocoagulation. Free Radic Biol Med 1991;11:327-330.
Dharma S, Bazan HE, Peyman GA, Atef MS. Production of platelet-activating factor in photocoagulated retinas. Curr Eye Res 1991;10:1031-1035.
Nonaka A, Kiryu J, Tsujikawa A, Yamashiro K, Nishijima K, Kamizuru H, et al. Inflammatory response after scatter laser photocoagulation in nonphotocoagulated retina. Invest Ophthalmol Vis Sci 2002;43:1204-1209.
Toth CA, Birngruber R, Boppart SA, Hee MR, Fujimoto JG, DiCarlo CD, et al. Argon laser retinal lesions evaluated in vivo by optical coherence tomography. Am J Ophthalmol 1997;123:188-198.
Scott IU, Danis RP, Bressler SB, Bressler NM, Browning DJ, Qin H. Effect of focal/grid photocoagulation on visual acuity and retinal thickening in eyes with non center-involved diabetic macular edema. Retina 2009;29:613-617.
Kuppermann BD, Blumenkranz MS, Haller JA, Williams GA, Weinberg DV, Chou C, et al. Randomized controlled study of an intravitreous dexamethasone drug delivery system in patients with persistent macular edema. Arch Ophthalmol 2007;125:309-317.
Lam DS, Chan CK, Mohamed S, Lai Ty, Li KK, Li PS, et al. A prospective randomised trial of different doses of intravitreal triamcinolone for diabetic macular edema. Br J Ophthalmol 2007;91:199-203.
Rudnisky CJ, Lavergne V, Katz D. Visual acuity after intravitreal triamcinolone for diabetic macular edema refractory to laser treatment: a meta-analysis. Can J Ophthalmol 2009;44:587-592.
Arevalo JF, Fromow-Guerra J, Quiroz-Mercado H, Sanchez JG, Wu L, Maia M, et al. Primary intravitreal bevacizumab (Avastin) for diabetic macular edema: results from the Pan-American Collaborative Retina Study Group at 6-month follow-up. Ophthalmology 2007;114:743-750.
Scott IU, Edwards AR, Beck RW, Bressler NM, Chan CK, Elman MJ, et al. A phase II randomized clinical trial of intravitreal bevacizumab for diabetic macular edema. Ophthalmology 2007;114:1860-1867.
Biallosterski C, van Velthoven ME, Michels RP, Schlingemann RO, DeVries JH, Verbraak FD. Decreased optical coherence tomography- measured pericentral retinal thickness in patients with diabetes mellitus type 1 with minimal diabetic retinopathy. Br J Ophthalmol 2007;91:1135-1138.
Chan A, Duker JS, Ko TH, Fujimoto JG, Schuman JS. Normal macular thickness measurements in healthy eyes using Stratus optical coherence tomography. Arch Ophthalmol 2006;124:193-198.
Browning DJ, Glassman AR, Aiello LP, Beck RW, Brown DM, Fong DS, et al. Relationship between optical coherence tomography-measured central retinal thickness and visual acuity in diabetic macular edema. Ophthalmology 2007;114:525-536.
Early Treatment Diabetic Retinopathy Study research group. Photocoagulation for diabetic macular edema. Early Treatment Diabetic Retinopathy Study report number 1. Arch Ophthalmol 1985;103:1796-1806.
Minassian DC, Rosen P, Dart JK, Reidy A, Desai P, Shidu M, et al. Extracapsular cataract extraction compared with small incision surgery by phacoemulsification: a randomised trial. Br J Ophthalmol 2001;85:822-829.
>Cirugía y Cirujanos
>Year 2011, Issue 5