Laser still the mainstay of macular oedema treatment

While the introduction of anti-VEGF therapies is transforming the clinical management of diabetic macular oedema (DME), focal laser photocoagulation still remains the gold standard in the initial treatment of the disease, according to David Pelayes MD. "We now have more options thanks to anti-VEGF therapies, but focal laser is not going to disappear from our treatment arsenal. Reducing the side effects and improving the safety and efficacy of the therapy are some of the central aims of contemporary laser photocoagulation," he told delegates attending the European Society of Ophthalmology (SOE) 2017 Congress in Barcelona, Spain. Dr Pelayes, Full Professor of Ophthalmology, Buenos Aires University, Argentina, and Full Professor of Ophthalmology, Maimonides University, noted that the parameters of laser photocoagulation have evolved in recent clinical studies by incorporating shorter pulse durations and lower laser energy. "Clinical trials have demonstrated that lower energy can reduce side effects and risks while effectively alleviating DME," he said.

Clinical trials have demonstrated that lower energy can reduce side effects and risks while effectively alleviating DME

The general macular settings for the laser now include an exposure time of 10 to 20 milliseconds, resulting in sharply decreased energy density and thermal diffusion, he explained. "Furthermore, studies have shown that the retinal photocoagulation induced by 10 to 30 ms exposure time can stimulate inner retinal healing responses and is associated with less destructive effects than traditional methods," he said.

Tags: macular oedema, retina