Azzouz Lyna, Durrani Asad, Zhou Yunshu, Paulus Yannis M
Department of Ophthalmology and Visual Sciences, University of Michigan, Ann Arbor, MI 48105, USA.
Department of Ophthalmology, Stanford University, Palo Alto, CA 94305, USA.
Photonics. 2023 Oct;10(10). doi: 10.3390/photonics10101165. Epub 2023 Oct 18.
This study aims to determine the impact of adjunct nondamaging focal laser therapy on the number of anti-vascular endothelial growth factor (anti-VEGF) injections and visual acuity (VA) and imaging in patients with diabetic macular edema (DME). A retrospective analysis of 18 eyes of 14 patients with DME treated with a single session of the PASCAL 532 nm Synthesis Photocoagulator with Endpoint Management was conducted. Demographic data, VA, imaging, laser parameters, and anti-VEGF injection burden six months before and after treatment were collected. Wilcoxon Signed-rank tests were used to assess changes in VA and injection burden before and after treatment. The mean number of intravitreal injections in the six-month period prior to laser treatment was 3.39 ± 2.57 injections compared to 2.33 ± 2.40 injections following laser treatment ( = 0.02). There was no significant difference between the mean VA on the day of treatment logMAR VA of 0.38 ± 0.27 (approx. Snellen equivalent 20/50) and the visual acuity on the most recent follow-up 6 months after laser logMAR VA of 0.35 ± 0.32 (approx. Snellen equivalent 20/40) ( = 0.34). There was also no significant difference in OCT central macular thickness before (311 μm) compared to 6 months after (301 μm, = 0.64). Adjunct focal macular laser therapy is associated with a statistically and clinically significant decrease in the number of intravitreal injections required in the six-month period immediately following treatment, without compromising visual acuity or macular thickness. Nondamaging focal laser has the potential to alleviate the burden of injections for both patients and clinics.
本研究旨在确定辅助性无创聚焦激光治疗对糖尿病性黄斑水肿（DME）患者抗血管内皮生长因子（抗VEGF）注射次数、视力（VA）及影像学的影响。对14例DME患者的18只眼进行回顾性分析，这些患者接受了单次使用带有终点管理功能的PASCAL 532 nm合成光凝器的治疗。收集了治疗前后6个月的人口统计学数据、视力、影像学、激光参数及抗VEGF注射负担。采用Wilcoxon符号秩检验评估治疗前后视力和注射负担的变化。激光治疗前6个月玻璃体内注射的平均次数为3.39±2.57次，而激光治疗后为2.33±2.40次（P = 0.02）。治疗当天的平均视力logMAR视力为0.38±0.27（约相当于Snellen视力表的20/50）与激光治疗后6个月最近一次随访时的视力logMAR视力为0.35±0.32（约相当于Snellen视力表的20/40）之间无显著差异（P = 0.34）。光学相干断层扫描（OCT）测量的黄斑中心厚度治疗前（311μm）与6个月后（301μm，P = 0.64）相比也无显著差异。辅助性黄斑聚焦激光治疗与治疗后立即出现的6个月期间所需玻璃体内注射次数在统计学和临床上的显著减少相关，且不影响视力或黄斑厚度。无创聚焦激光有潜力减轻患者和诊所的注射负担。
