Takashina Hirotsugu, Watanabe Akira, Komatsu Koji, Nakano Tadashi
Department of Ophthalmology, Tokyo Rosai Hospital, Tokyo, Japan.
Department of Ophthalmology, The Jikei University School of Medicine, Tokyo, Japan.
Clin Ophthalmol. 2021 May 4;15:1827-1830. doi: 10.2147/OPTH.S309828. eCollection 2021.
Subthreshold photocoagulation is one of the treatments for diabetic macular edema. However, the range of adequate laser energy that can be used for subthreshold photocoagulation is very restricted. Therefore, determination of the titration settings for the threshold energy is an essential part of the subthreshold-photocoagulation procedure. This study examined factors influencing the threshold energy used in subthreshold photocoagulation for diabetic macular edema.
For 20 consecutive cases (29 eyes) who had received treatment using Endpoint Management (EpM) between April 2019 and June 2020 for persistent diabetic macular edema after completion of panretinal photocoagulation, multiple regression analysis was used to examine factors influencing threshold energy.
Analysis evaluating all the surgical procedures (n=150) determined there was statistical significance for a history of vitrectomy and cataract surgery, central macular thickness, interval from completion of panretinal photocoagulation, superior 6 mm subfield, and nasal 6 mm subfield. Further analysis examined surgical procedures that had been done in patients with a history of vitrectomy and cataract surgery (n=116). This analysis showed that central macular thickness, axial length, interval from completion of panretinal photocoagulation, and HbA were all statistically significant factors.
Threshold energy for diabetic macular edema was significantly influenced by a history of vitrectomy and cataract surgery, central macular thickness, and interval between the completion of panretinal photocoagulation and initial EpM. Transparency of ocular media and intraocular inflammation were speculated to be associated with these results.
阈下光凝是治疗糖尿病性黄斑水肿的方法之一。然而，可用于阈下光凝的适当激光能量范围非常有限。因此，确定阈能的滴定设置是阈下光凝程序的重要组成部分。本研究探讨了影响糖尿病性黄斑水肿阈下光凝中阈能的因素。
对于2019年4月至2020年6月期间连续20例（29只眼）在完成全视网膜光凝后因持续性糖尿病性黄斑水肿接受终点管理（EpM）治疗的患者，采用多元回归分析来研究影响阈能的因素。
对所有手术操作（n = 150）的分析确定，玻璃体切除术和白内障手术史、黄斑中心厚度、全视网膜光凝完成后的间隔时间、上方6 mm子区域和鼻侧6 mm子区域具有统计学意义。进一步分析了有玻璃体切除术和白内障手术史的患者所进行的手术操作（n = 116）。该分析表明，黄斑中心厚度、眼轴长度、全视网膜光凝完成后的间隔时间和糖化血红蛋白均为具有统计学意义的因素。
糖尿病性黄斑水肿的阈能受玻璃体切除术和白内障手术史、黄斑中心厚度以及全视网膜光凝完成与初次EpM之间的间隔时间显著影响。推测眼介质透明度和眼内炎症与这些结果有关。
