Akkaya Sezen, Açıkalın Banu, Doğan Yusuf Emre, Çoban Fatih
Departmant of Ophthalmology, Sağlık Bilimleri University, FSM Training and Research Hospital, İstanbul 34752, Turkey.
Int J Ophthalmol. 2020 Oct 18;13(10):1606-1611. doi: 10.18240/ijo.2020.10.15. eCollection 2020.
To compare the effects of yellow (577 nm) subthreshold micropulse laser (SML) and intravitreal (IV) anti-vascular endothelial growth factor (VEGF) treatment in patients with diabetic macular edema (DME) with relatively better visual acuity [best corrected visual acuity (BCVA) ≤0.15 logMAR].
The medical records of 76 eyes of 47 patients underwent IV (0.5 mg) anti-VEGF injection or SML for the DME with relatively better BCVA were reviewed. The IV group received three consecutive monthly IV anti-VEGF injections, then were retreated as needed. The laser treatment group was treated at baseline and 3mo, and then retreated at 6 and 9mo if needed. All participants were followed up for one year. The mean BCVA and mean central macular thickness (CMT) values changes over the follow-up were evaluated.
Twenty-four and 23 patients were assigned to the SML and IV subgroups, respectively. The mean number of treatments was 3.64±0.76 in SML group and 5.85±1.38 in IV group (<0.05). The subgroups were similar with regard to the mean BCVA score at baseline and at the 1 and 3 months, but the score of SML group was better than that of IV group at the 6, 9, and 12 months (<0.05). The decrease in the mean CMT values from baseline values was higher in SML group at the 6, 9, and 12 months (<0.05).
Yellow SML treatment is superior to IV anti-VEGF injection in DME patients with relatively better BCVA for increasing visual acuity and decreasing CMT at 6, 9, and 12mo. SML can be a good alternative first-line therapy for DME with BCVA ≤0.15 logMAR.
比较黄色（577纳米）阈下微脉冲激光（SML）与玻璃体内（IV）注射抗血管内皮生长因子（VEGF）治疗对视力相对较好[最佳矫正视力（BCVA）≤0.15 logMAR]的糖尿病性黄斑水肿（DME）患者的疗效。
回顾了47例接受IV（0.5毫克）抗VEGF注射或SML治疗的视力相对较好的DME患者的76只眼的病历。IV组每月连续3次玻璃体内注射抗VEGF，然后根据需要进行再次治疗。激光治疗组在基线和3个月时接受治疗，如有需要在6个月和9个月时进行再次治疗。所有参与者均随访1年。评估随访期间平均BCVA和平均中心黄斑厚度（CMT）值的变化。
分别有24例和23例患者被分配到SML和IV亚组。SML组的平均治疗次数为3.64±0.76次，IV组为5.85±1.38次（<0.05）。在基线以及1个月和3个月时，亚组的平均BCVA评分相似，但在6个月、9个月和12个月时，SML组的评分优于IV组（<0.05）。在6个月、9个月和12个月时，SML组平均CMT值相对于基线值的降低幅度更大（<0.05）。
对于BCVA相对较好的DME患者，黄色SML治疗在提高视力以及在6个月、9个月和12个月时降低CMT方面优于玻璃体内注射抗VEGF。对于BCVA≤0.15 logMAR的DME，SML可以作为一种良好的一线治疗替代方案。
