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Early Nd:YLF laser treatment deemed promising for DME
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LISBON, Portugal — A multicenter pilot study found that neodymium:YLF laser treatment of selected retinal pigment cells is promising for treatment of diabetic macular edema, according to a speaker here.
Peter Hamilton, MD, FRACS, said the Nd:YLF laser selectively treats retinal pigment epithelial (RPE) cells by creating a thermal reaction within the RPE at between 100· and 160·. The reaction is confined to the RPE, he said.
Selective treatment of RPE “avoids photoreceptor damage and central visual field defects,” Dr. Hamilton said, speaking here at the Euretina meeting.
The Nd:YLF laser used in the study has a wavelength of 527 nm, pulse duration of 0.2 seconds, spot size of about 200 µm, and pulse rate of 100 Hz, he said.
The laser spots “create minimal collateral damage, allowing the sparing of the photoreceptors,” Dr. Hamilton said. He described results of a phase 1 pilot study performed in London and at three sites in Germany with 20 patients at each site.
The study graded the effectiveness of Nd:YLF laser for treatment of diabetic macular edema based on improvement of visual acuity, reduction of hard exudates, reduction of leakage on fluorescein angiography and reduction of retinal thickness as measured by optical coherence tomography, Dr. Hamilton said.
“At 6 months follow up, 90% of patients (49/55) had better or stable vision,” he reported. “Laser scars were not visible on [angiography] in 17 out of 20 eyes of the London patients.”
For the future, Dr. Hamilton recommended a trial comparing the Nd:YLF treatment to conventional argon laser.