Eyeworld

EW INTERNATIONAL 80 December 2016 modified ETDRS photocoagulation in terms of anatomic and function measures of improvement. The trial randomly assigned 123 previously untreated DME patients to receive mETDRS, normal density SDM, or high density SDM. It showed a sig- nificant improvement in visual acu- ity of 2.5 lines, which was compara- ble to visual improvements notably obtained using anti-VEGF drugs. 4 "In our study, subthreshold laser treatments resulted in equal or bet- ter efficacy than conventional laser photocoagulation in patients with DME. At least one study has shown improvement in visual acuity after subthreshold laser treatment similar to anti-VEGF. Subthreshold laser is more cost effective and superior to anti-VEGF drugs in patients with a thinner retinal profile. Further eval- uation is necessary to compare anti- VEGF therapy with subthreshold laser in DME patients with thinner retinal profiles," Dr. Sarao said. EW References 1. Focal photocoagulation treatment of diabetic macular edema. Relationship of treatment effect to fluorescein angiographic and other retinal characteristics at baseline: ETDRS report no. 19. Early Treatment Diabetic Retinopathy Study Research Group. Arch Ophthalmol. 1995;113:1144–1155. 2. Mitchell P, et al. The RESTORE study: ranibi- zumab monotherapy or combined with laser versus laser monotherapy for diabetic macular edema. Ophthalmology. 2011;118:615–25. 3. Bandello F, et al. "Light" versus "classic" laser treatment for clinically significant diabetic macular oedema. Br J Ophthalmol. 2005;89:864–870. 4. Lavinsky D, et al. Randomized clinical trial evaluating mETDRS versus normal or high-density micropulse photocoagulation for diabetic macular edema. Invest Ophthalmol Vis Sci. 2011;52:4314–23. Editors' note: Dr. Sarao has no finan- cial interest related to her comments. Contact information Sarao: sarao.valentina@gmail.com Lasers continued from page 79 account in our jobs. Sometimes a good doctor has to be a bad busi- nessman. We have one of the best health care systems worldwide, and we want to keep it that way. I started with a plea for academic ophthal- mology and am finishing with a plea to preserve the type of ophthalmol- ogy that cares about the good of the patient and against a purely for-prof- it attitude toward what we do." Reigniting continued from page 78 Compassion According to Dr. Batz, human compassion and profitability are not necessarily mutually exclusive and can be implemented in balance with one another. When trying to assert yourself in the medical market, as a doctor, you cannot neglect the call- ing of your profession. When caring for the needy, he thinks that profit orientation is possible, as long as it is conducted with a careful use of resources and most importantly with patients in mind. He maintained that earning is a means to an end for patient care and that care is not a means to maximize profits. Dr. Batz told attendees that patients are not subjects or cases and doctors not mere functionaries. In health care, when dealing with life and death, empathy needs to be the main exercise. People are the point, not the means, he said. EW Editors' note: Drs. Helbig and Batz have no financial interest related to their comments. Contact information Batz: ro-batz@t-online.de Helbig: horst.helbig@ukr.de BAF NIR Baseline 1 hour 1 week 2 weeks 1 month 2 months IR 3 months Subthreshold laser treatment Case 1I Spot laser detection after µP laser Case 2: Spot laser detection after μP laser Source (all): Valentina Sarao, MD BAF NIR Baseline 1 hour 1 week 2 weeks 1 month 2 months 3 months IR Subthreshold laser treatment Case 1 Spot laser detection after Pascal with EpM Case 1: Spot laser detection after Pascal with EpM Detectable laser spots were higher in patients treated with continuous wave laser with endpoint manage- ment technology than those treated with micropulse strategy. Laser spot characteristics were more evident with blue light autofluorescence than near infrared fundus autofluo- rescence," she said. Dr. Sarao cited a randomized clinical trial in which subthreshold diode laser micropulse photocoag- ulation was seen to be superior to

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