Eyeworld

OCT 2014

EyeWorld is the official news magazine of the American Society of Cataract & Refractive Surgery.

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115 EW RETINA October 2014 Contact information Mansour: smansour@virginiaretina.com using the IQ 577 laser at 400 mW, with a 5% duty cycle and a 200-ms duration. I used a 200-micron spot and an Area Centralis lens (Volk Optical, Mentor, Ohio) to deliver 83 spots to the fovea. When he re- turned for follow-up 1 month later, the edema had resolved (Figure 2). Areas CW laser doesn't work There are a variety of situations where we have concluded that CW laser is not the most effective treat- ment. The previously mentioned VIBRANT study showed minimal benefit of standard grid CW laser for macular edema related to BRVO. 4 The swelling from CW laser set up that treatment to fail. However, the emergence of MPLT changes the understanding of the treatment mechanism sufficiently that it merits revisiting many of these situations. Now that pharmaceutical treatment can be used, there may be a role for MPLT to enhance that effect. MicroPulse photo-stimulates cells without damage, enhancing RPE function and endothelial cells in the retinal vasculature, 5 and that certainly is an area worth studying further. EW References 1. Early Treatment Diabetic Retinopathy Study Research Group: Focal photocoagulation treatment of diabetic macular edema. ETDRS Report Number 19. Arch Ophthalmol 113: 1144–1155, 1995. 2. Lavinsky D, Cardillo JA, Melo LA Jr, Dare A, Fareh ME, Belfort R Jr. Randomized clinical trial evaluating mETDRS versus normal or high-density micropulse photocoagulation for diabetic macular edema. Invest Ophthalmol Vis Sci. 2011 Jun 17;52(7):4314–23. 3. Luttrull JK, Dorin G. Subthreshold Diode Micropulse Laser Photocoagulation (SDM) as Invisible Retinal Phototherapy for Diabetic Macular Edema: A Review. Curr Diabetes Rev. 2012 July; 8(4): 274–284. 4. www.asrs.org/education/clinical- updates/142/vibrant-study-yields-positive- results-for-eylea-in-treating-macular-edema- following-brvo 5. Ogata N, Tombran-Tink J, Jo N, Mrazek D, Matsumura M. Upregulation of pigment epi- thelium-derived factor after laser photocoagu- lation. Am J Ophthalmol. 2001;132:427–429. Dr. Mansour is clinical professor, Department of Ophthalmology, George Washington University in Washington, D.C., and medical director of the Virginia Retina Center, with 3 locations in Northern Virginia. He has financial interests with Iridex.

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