Vujosevic Stela, Frizziero Luisa, Martini Ferdinando, Bini Silvia, Convento Enrica, Cavarzeran Fabiano, Midena Edoardo
Ophthalmic Surg Lasers Imaging Retina. 2018 Nov 1;49(11):e218-e225. doi: 10.3928/23258160-20181101-22.
A pilot prospective, interventional study has been conducted on 10 patients with diabetic macular edema (DME) treated with subthreshold micropulse laser (SMPL) to evaluate changes of individual retinal layers and to correlate with functional changes. All patients underwent complete ophthalmologic evaluation including spectral-domain optical coherence tomography (OCT) and microperimetry at baseline, 3 months, 6 months, 9 months, and 12 months. Compared with baseline, a significant decrease was found in inner nuclear layer (INL) and outer retinal layer (ORL) thickness in the central 1 mm (P < .05). Increase in best-corrected visual acuity was significantly and inversely correlated to central retinal thickness (CRT) (P = .0027), INL (P = .0167), and outer nuclear layer (ONL) thickness (P = .0107). Increase in retinal sensitivity was significantly and inversely correlated to CRT and ONL thickness (P < .01). Therefore, SMPL showed to improve firstly functional parameters and then morphologic parameters. Functional parameters were inversely correlated to CRT, INL, and ONL thickness. The exact mechanism of reduction of INL thickness induced by SMPL remains to be further evaluated. [Ophthalmic Surg Lasers Imaging Retina. 2018;49:e218-e225.].
一项前瞻性干预性试点研究对10例接受阈下微脉冲激光（SMPL）治疗的糖尿病性黄斑水肿（DME）患者进行，以评估视网膜各层的变化并与功能变化相关联。所有患者在基线、3个月、6个月、9个月和12个月时均接受了包括光谱域光学相干断层扫描（OCT）和微视野检查在内的全面眼科评估。与基线相比，中央1毫米处的内核层（INL）和视网膜外层（ORL）厚度显著降低（P <.05）。最佳矫正视力的提高与中央视网膜厚度（CRT）（P =.0027）、INL（P =.0167）和外核层（ONL）厚度（P =.0107）显著负相关。视网膜敏感度的提高与CRT和ONL厚度显著负相关（P <.01）。因此，SMPL首先显示出改善功能参数，然后改善形态学参数。功能参数与CRT、INL和ONL厚度呈负相关。SMPL诱导INL厚度降低的确切机制仍有待进一步评估。[《眼科手术、激光与视网膜成像》。2018；49：e218 - e225。]
