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- Title
Comparison of two-year treatment outcomes between subthreshold micropulse (577 nm) laser and aflibercept for diabetic macular edema.
- Authors
Lai, Frank Hiu Ping; Chan, Rose P. S.; Lai, Anthony C. H.; Tsang, Susanna; Woo, Tiffany T. Y.; Lam, Robert F.; Yuen, Can Y. F.
- Abstract
Purpose: To compare two-year treatment outcomes of subthreshold micropulse (577 nm) laser and aflibercept for diabetic macular edema (DME). Study design: Retrospective case–control study. Methods: A total 164 eyes in 164 DME patients treated with either micropulse laser (86 eyes) or intravitreal aflibercept monotherapy (78 eyes) were recruited. Main outcome measures included at least five Early Treatment Diabetic Retinopathy Study (ETDRS) letters' improvement from baseline at 6, 12 and 24 months. Results: Rescue aflibercept was initiated in 24% of eyes in micropulse laser group. At 6-month visit the aflibercept group achieved a higher percentage of eyes with at least 5-letter visual acuity improvement than micropulse laser group (56% vs 38%, P = 0.044), however, this was not the case at 12-month (45% vs 49%, P = 0.584) and 24-month visits (49% vs 57%, P = 0.227). At 6-month visit the aflibercept group achieved a higher percentage of eyes with at least 10% improvement of central macular thickness (73% vs 49%, P = 0.005), but this was not the case at 12-month (73% vs 70%, P = 0.995) and 24-month visits (85% vs 84%, P = 0.872). Conclusion: Aflibercept achieved faster and higher rates of anatomical and functional improvement than micropulse laser in DME patients. Long term efficacy of treatment did not result in significant differences between aflibercept monotherapy and micropulse laser in DME patients. Primary treatment of micropulse laser with deferred rescue aflibercept might be the treatment option without reducing the chance of visual improvement in DME eyes.
- Subjects
MACULAR edema; AFLIBERCEPT; TREATMENT effectiveness; DIABETIC retinopathy; LASERS; VISUAL acuity
- Publication
Japanese Journal of Ophthalmology, 2021, Vol 65, Issue 5, p680
- ISSN
0021-5155
- Publication type
Article
- DOI
10.1007/s10384-021-00846-4