title: Retina rejuvenation therapy for diabetic macular edema: a pilot study.
abstract: OBJECTIVE
  To prospectively investigate the safety and efficacy of a novel frequency-doubled nanosecond-pulsed laser with discontinuous beam energy distribution (2RT, Ellex) for the treatment of diabetic macular edema.
  
  
  METHODS
  Twenty-three consecutive patients (38 eyes) with newly diagnosed diabetic macular edema were recruited and assessed with logarithm of the minimum angle of resolution best-corrected visual acuity, central macular thickness measured with optical coherence tomography (OCT/scanning laser ophthalmoscope, OPKO/OTI), microperimetry, fundus photography, and fundus fluorescein angiography. Macular grid treatments were performed with 2RT laser system by 1 operator. Patients were examined with logarithm of the minimum angle of resolution best-corrected visual acuity, central macular thickness, microperimetry, and fundus photography at 3 weeks and 6 weeks and 3 months and 6 months. Fundus fluorescein angiography was repeated at 3 months and 6 months.
  
  
  RESULTS
  Six months postoperatively, 17 patients (28 eyes) completed the study. No complications were identified after 2RT therapy. Intraoperative retinal discoloration was observed in 2 cases, fully resolved at 3 months with no permanent anatomical or functional changes. Mean logarithm of the minimum angle of resolution visual acuity improved from 20/44 at baseline to 20/27 at 6 months. The change in best-corrected visual acuity was significant (P = 0.0190). Central macular thickness in the central 1-mm subfield, retinal exudates and vascular leakage decreased in the majority of patients at 6 months (46, 41, and 55%, respectively), although the change from baseline was not statistically significant. Microperimetry confirmed photoreceptor integrity and showed a trend of improvement that correlated with decreased central macular thickness.
  
  
  CONCLUSIONS
  For the first time, we achieved a beneficial effect on diabetic macular edema without the side effects of conventional laser therapy. The efficacy of this system in comparison with standard argon laser photocoagulation and in the treatment of other conditions affecting the retinal pigment epithelium needs further investigation.
authors.affiliation: King's College London University, London, United Kingdom. luciapelosini@googlemail.com
authors.forename: Lucia
authors.initials: L
authors.lastname: Pelosini
authors.forename: Robin
authors.initials: R
authors.lastname: Hamilton
authors.forename: Moin
authors.initials: M
authors.lastname: Mohamed
authors.forename: A M Peter
authors.initials: AM
authors.lastname: Hamilton
authors.forename: John
authors.initials: J
authors.lastname: Marshall
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D003930:Diabetic Retinopathy / Q000503:physiopathology / Q000601:surgery*; D005260:Female; D005451:Fluorescein Angiography; D006801:Humans; D028022:Low-Level Light Therapy; D008266:Macula Lutea / Q000473:pathology; D008269:Macular Edema / Q000503:physiopathology / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D010865:Pilot Projects; D011446:Prospective Studies; D012160:Retina / Q000502:physiology*; D041623:Tomography, Optical Coherence; D016896:Treatment Outcome; D014792:Visual Acuity / Q000502:physiology; D058609:Visual Field Tests