Parodi Maurizio Battaglia, Spasse Sonela, Iacono Pierluigi, Di Stefano Giuseppe, Canziani Tiziana, Ravalico Giuseppe
Eye Clinic, Azienda Ospedaliero-Universitaria di Trieste, Trieste, Italy.
Ophthalmology. 2006 Dec;113(12):2237-42. doi: 10.1016/j.ophtha.2006.05.056. Epub 2006 Sep 25.
To compare the effectiveness of subthreshold grid laser treatment (SGLT) with an infrared micropulse diode laser with that of threshold grid laser treatment (TGLT) for macular edema secondary to branch retinal vein occlusion (BRVO).
Randomized clinical trial.
Thirty-six patients (36 eyes) were randomized either to infrared SGLT (17 eyes) or to krypton TGLT (19 eyes).
Complete ophthalmic examinations, including determination of visual acuity (VA) with Early Treatment Diabetic Retinopathy Study charts, optical coherence tomography (OCT), and fluorescein angiography, were performed at the time of the study entry and at 6-month intervals, with a planned follow-up of 24 months.
Primary: decrease in mean foveal thickness (FT) on OCT. Secondary: changes of the total macular volume (TMV) over the follow-up, proportion of eyes that gained at least 10 letters (approximately > or =2 lines of VA gain) at the 12- and 24-month examinations, and timing of macular edema resolution.
Changes in mean FT and TMV from the initial values were statistically significant for TGLT from the 6-month examination (P<0.001) and for SGLT from the 12-month examination (P<0.001). After 1 year, there was no difference in mean FT and TMV between the 2 groups. At the 12-month examination, 10 patients of the SGLT group (59%) and 11 of the TGLT group (58%) gained at least 10 letters (2 lines) in VA. At the 24-month examination, this gain was achieved by 11 patients (65%) of the SGLT group and 11 (58%) of the TGLT group. Moreover, at the 24-month examination 59% and 26% gained 3 lines in the SGLT and TGLT groups, respectively.
Resolution of macular edema and VA improvement are similar to those obtained with conventional TGLT, but SGLT is not associated with biomicroscopic and angiographic signs. A multicenter randomized clinical trial would be needed to ascertain the real efficacy and the most appropriate settings of SGLT for macular edema secondary to BRVO.
比较阈下格栅激光治疗（SGLT）联合红外微脉冲二极管激光与阈上格栅激光治疗（TGLT）对视网膜分支静脉阻塞（BRVO）继发黄斑水肿的疗效。
随机临床试验。
36例患者（36只眼）被随机分为红外SGLT组（17只眼）或氪离子TGLT组（19只眼）。
在研究入组时及每隔6个月进行一次全面的眼科检查，包括使用糖尿病视网膜病变早期治疗研究图表测定视力（VA）、光学相干断层扫描（OCT）和荧光素血管造影，计划随访24个月。
主要指标：OCT上平均黄斑中心凹厚度（FT）的降低。次要指标：随访期间黄斑总体积（TMV）的变化、在12个月和24个月检查时视力至少提高10个字母（约≥2行VA提高）的眼的比例，以及黄斑水肿消退的时间。
从6个月检查起，TGLT组的平均FT和TMV相对于初始值的变化具有统计学意义（P<0.001），从12个月检查起，SGLT组的变化具有统计学意义（P<0.001）。1年后，两组的平均FT和TMV无差异。在12个月检查时，SGLT组10例患者（59%）和TGLT组11例患者（58%）的视力至少提高了10个字母（2行）。在24个月检查时，SGLT组11例患者（65%）和TGLT组11例患者（58%）达到了这一提高。此外，在24个月检查时，SGLT组和TGLT组分别有59%和26%的患者视力提高了3行。
黄斑水肿的消退和视力改善与传统TGLT相似，但SGLT不伴有生物显微镜和血管造影体征。需要进行多中心随机临床试验来确定SGLT对BRVO继发黄斑水肿的实际疗效和最合适的治疗参数。
