The treatment of macular disease using a micropulsed and continuous wave 810-nm diode laser.
OBJECTIVE
The purpose of the study is to determine whether the 810-nm diode wavelength using a rectangular waveform is clinically effective in the treatment of choroidal neovascularization from age-related macular degeneration and to determine whether macular edema secondary to branch vein occlusion or diabetic retinopathy can be effectively treated with this laser using the micropulse waveform.


METHODS
Review of consecutive nonrandomized patients whose eyes were treated with the diode laser over a 30-month period.


METHODS
Fifty-three patients with an initial presentation of choroidal neovascularization located subfoveally (77%), extrafoveally (17%), and juxtafoveally (6%); 14 patients with macular edema from a branch vein occlusion; and 59 patients with diabetic macular edema, 40 of which were treated for the first time.


METHODS
Ablative rectangular wave laser photocoagulation was applied to the choroidal neovascular membranes and very light threshold treatment was applied in a macular grid to treat retinal edema. Microaneurysms were not targeted.


METHODS
Anatomic resolution of macular edema or choroidal neovascularization and visual acuity.


RESULTS
Sixty percent of eyes treated for choroidal neovascularization had no persistence or recurrence at 6 months, and 72% achieved visual stabilization. In 8% of eyes, some localized bleeding occurred during photocoagulation. Clinical resolution of macular edema from branch vein occlusion occurred by 6 months in 92% of eyes, and 77% had stabilization of visual acuity. At 6 months, 76% of newly treated patients with diabetic macular edema and 67% of previously treated patients had clinical resolution of their edema. Vision was improved or stabilized in 91% and 73% of newly treated and retreated patients at 6 months, respectively.


CONCLUSIONS
The micropulsed 810-nm diode laser is clinically effective in the treatment of macular edema from venous occlusion and diabetic retinopathy, and the rectangular (normal) mode diode laser can be used in many eyes with choroidal neovascularization.
Friberg
T R
TR
Eye and Ear Institute and the Department of Ophthalmology, University of Pittsburgh School of Medicine, Pennsylvania 15213, USA.
Karatza
E C
EC
D000368:Aged; D002829:Choroid / Q000098:blood supply*; D003930:Diabetic Retinopathy / Q000150:complications*; D005260:Female; D005451:Fluorescein Angiography; D005654:Fundus Oculi; D006801:Humans; D017075:Laser Coagulation; D008268:Macular Degeneration / Q000150:complications*; D008269:Macular Edema / Q000209:etiology / Q000503:physiopathology / Q000601:surgery*; D008297:Male; D009389:Neovascularization, Pathologic / Q000209:etiology / Q000503:physiopathology / Q000601:surgery*; D012170:Retinal Vein Occlusion / Q000150:complications*; D016896:Treatment Outcome; D014792:Visual Acuity / Q000502:physiology