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Bodea F, Bungau SG, Bogdan MA, Vesa CM, Radu A, Tarce AG, Purza AL, Tit DM, Bustea C, Radu AF. Micropulse Laser Therapy as an Integral Part of Eye Disease Management. MEDICINA (KAUNAS, LITHUANIA) 2023; 59:1388. [PMID: 37629677 PMCID: PMC10456532 DOI: 10.3390/medicina59081388] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/03/2023] [Revised: 07/25/2023] [Accepted: 07/28/2023] [Indexed: 08/27/2023]
Abstract
Ocular diseases can significantly impact vision and quality of life through pathophysiological alterations to the structure of the eye. The management of these conditions often involves a combination of pharmaceutical interventions, surgical procedures, and laser therapy. Laser technology has revolutionized many medical fields, including ophthalmology, offering precise and targeted treatment options that solve some of the unmet needs of other therapeutic strategies. Conventional laser techniques, while effective, can generate excessive thermal energy, leading to collateral tissue damage and potential side effects. Compared to conventional laser techniques, micropulse laser therapy delivers laser energy in a pulsed manner, minimizing collateral damage while effectively treating target tissues. The present paper highlights the advantages of micropulse laser therapy over conventional laser treatments, presents the implications of applying these strategies to some of the most prevalent ocular diseases, and highlights several types and mechanisms of micropulse lasers. Although micropulse laser therapy shows great potential in the management of ocular diseases, further research is needed to optimize treatment protocols, evaluate long-term efficacy, and explore its role in combination therapies.
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Affiliation(s)
- Flaviu Bodea
- Doctoral School of Biomedical Sciences, University of Oradea, 410087 Oradea, Romania; (F.B.); (C.M.V.); (D.M.T.); (A.-F.R.)
| | - Simona Gabriela Bungau
- Doctoral School of Biomedical Sciences, University of Oradea, 410087 Oradea, Romania; (F.B.); (C.M.V.); (D.M.T.); (A.-F.R.)
- Department of Pharmacy, Faculty of Medicine and Pharmacy, University of Oradea, 410028 Oradea, Romania;
| | - Mihaela Alexandra Bogdan
- Department of Pharmacy, Faculty of Medicine and Pharmacy, University of Oradea, 410028 Oradea, Romania;
| | - Cosmin Mihai Vesa
- Doctoral School of Biomedical Sciences, University of Oradea, 410087 Oradea, Romania; (F.B.); (C.M.V.); (D.M.T.); (A.-F.R.)
- Department of Preclinical Disciplines, Faculty of Medicine and Pharmacy, University of Oradea, 410073 Oradea, Romania
| | - Ada Radu
- Ducfarm Pharmacy, 410514 Oradea, Romania;
| | - Alexandra Georgiana Tarce
- Medicine Program of Study, Faculty of Medicine and Pharmacy, University of Oradea, 410073 Oradea, Romania;
| | - Anamaria Lavinia Purza
- Department of Pharmacy, Faculty of Medicine and Pharmacy, University of Oradea, 410028 Oradea, Romania;
| | - Delia Mirela Tit
- Doctoral School of Biomedical Sciences, University of Oradea, 410087 Oradea, Romania; (F.B.); (C.M.V.); (D.M.T.); (A.-F.R.)
- Department of Pharmacy, Faculty of Medicine and Pharmacy, University of Oradea, 410028 Oradea, Romania;
| | - Cristian Bustea
- Department of Surgery, Oradea County Emergency Clinical Hospital, 410169 Oradea, Romania;
| | - Andrei-Flavius Radu
- Doctoral School of Biomedical Sciences, University of Oradea, 410087 Oradea, Romania; (F.B.); (C.M.V.); (D.M.T.); (A.-F.R.)
- Department of Preclinical Disciplines, Faculty of Medicine and Pharmacy, University of Oradea, 410073 Oradea, Romania
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Iovino C, Iodice CM, Pisani D, Rosolia A, Testa F, Giannaccare G, Chhablani J, Simonelli F. Yellow Subthreshold Micropulse Laser in Retinal Diseases: An In-Depth Analysis and Review of the Literature. Ophthalmol Ther 2023; 12:1479-1500. [PMID: 36933125 PMCID: PMC10164197 DOI: 10.1007/s40123-023-00698-w] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2023] [Accepted: 03/01/2023] [Indexed: 03/19/2023] Open
Abstract
Yellow subthreshold micropulse laser (YSML) is a retinal laser capable of inducing a biologic response without causing thermal damage to the targeted tissue. The 577-nm YSML is delivered to the retina abiding by different protocols in which wavelength, power, duration, spot size and number of spots can be properly set to achieve the most effective and safe treatment response in various chorioretinal disorders. The ultrashort trains of power modulate the activation of the retinal pigment epithelium cells and intraretinal cells, such as Müller cells, causing no visible retinal scars. Subthreshold energy delivered by YSML stimulates the production of the heat-shock proteins, highly conserved molecules that protect cells against any sort of stress by blocking apoptotic and inflammatory pathways that cause cell damage. YSML treatment allows resorption of the subretinal fluid in central serous chorioretinopathy and intraretinal fluid in various conditions including diabetic macular edema, postoperative cystoid macular edema and other miscellaneous conditions. YSML also seems to modulate the development and progression of reticular pseudodrusen in dry age-related macular degeneration. The aim of this review is to discuss and summarize the safety and efficacy of YSML treatment in retinal diseases.
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Affiliation(s)
- Claudio Iovino
- Eye Clinic, Multidisciplinary Department of Medical, Surgical and Dental Sciences, University of Campania Luigi Vanvitelli, Naples, Italy
| | - Clemente Maria Iodice
- Eye Clinic, Multidisciplinary Department of Medical, Surgical and Dental Sciences, University of Campania Luigi Vanvitelli, Naples, Italy
| | - Danila Pisani
- Eye Clinic, Multidisciplinary Department of Medical, Surgical and Dental Sciences, University of Campania Luigi Vanvitelli, Naples, Italy
| | - Andrea Rosolia
- Eye Clinic, Multidisciplinary Department of Medical, Surgical and Dental Sciences, University of Campania Luigi Vanvitelli, Naples, Italy
| | - Francesco Testa
- Eye Clinic, Multidisciplinary Department of Medical, Surgical and Dental Sciences, University of Campania Luigi Vanvitelli, Naples, Italy
| | | | - Jay Chhablani
- UPMC Eye Centre, University of Pittsburgh, Pittsburgh, PA, USA.
| | - Francesca Simonelli
- Eye Clinic, Multidisciplinary Department of Medical, Surgical and Dental Sciences, University of Campania Luigi Vanvitelli, Naples, Italy
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3
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Subthreshold Micropulse Laser for Diabetic Macular Edema: A Review. J Clin Med 2022; 12:jcm12010274. [PMID: 36615074 PMCID: PMC9821545 DOI: 10.3390/jcm12010274] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2022] [Revised: 12/18/2022] [Accepted: 12/26/2022] [Indexed: 12/31/2022] Open
Abstract
Diabetic macular edema (DME) is one of the main causes of visual impairment in patients of working age. DME occurs in 4% of patients at all stages of diabetic retinopathy. Using a subthreshold micropulse laser is an alternative or adjuvant treatment of DME. Micropulse technology demonstrates a high safety profile by selectively targeting the retinal pigment epithelium. There are no standardized protocols for micropulse treatment, however, a 577 nm laser application over the entire macula using a 200 μm retinal spot, 200 ms pulse duration, 400 mW power, and 5% duty cycle is a cost-effective, noninvasive, and safe therapy in mild and moderate macular edemas with retinal thickness below 400 μm. Micropulse lasers, as an addition to the current gold-standard treatment for DME, i.e., anti-vascular endothelial growth factor (anti-VEGF), stabilize the anatomic and functional retinal parameters 3 months after the procedure and reduce the number of required injections per year. This paper discusses the published literature on the safety and application of subthreshold micropulse lasers in DME and compares them with intravitreal anti-VEGF or steroid therapies and conventional grid laser photocoagulation. Only English peer-reviewed articles reporting research within the years 2010-2022 were included.
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Frizziero L, Calciati A, Torresin T, Midena G, Parrozzani R, Pilotto E, Midena E. Diabetic Macular Edema Treated with 577-nm Subthreshold Micropulse Laser: A Real-Life, Long-Term Study. J Pers Med 2021; 11:jpm11050405. [PMID: 34067994 PMCID: PMC8152245 DOI: 10.3390/jpm11050405] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2021] [Revised: 05/10/2021] [Accepted: 05/11/2021] [Indexed: 12/30/2022] Open
Abstract
The aim of this study was to evaluate the long-term efficacy and safety of 577-nm subthreshold micropulse laser (SMPL) treatment in a large population of patients affected by mild diabetic macular edema (DME) in a real-life setting. We retrospectively evaluated 134 eyes affected by previously untreated center-involving mild DME, and treated with 577-nm SMPL, using fixed parameters. Retreatment was performed at 3 months, in case of persistent retinal thickening. Optical coherence tomography (OCT), along with short and near-infrared fundus autofluorescence, were used to confirm long-term safety. At the end of at least one year follow-up, a significant improvement in visual acuity was documented, compared to baseline (77.3 ± 4.5 and 79.4 ± 4.4 ETDRS score at baseline and at final follow-up, respectively), as well as a reduction in the mean retinal thickness of the thickest ETDRS macular sector at baseline. A reduction in the central retinal thickness and the mean thickness of the nine ETDRS sectors was also found, without reaching statistical significance. No patients required intravitreal injections. No adverse effects were detected. This study suggests that 577-nm SMPL is a safe and repeatable treatment for mild DME that may be applied to real-life clinical settings using fixed parameters and protocols.
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Affiliation(s)
- Luisa Frizziero
- Department of Neuroscience—Ophthalmology, University of Padova, 35128 Padova, Italy; (L.F.); (A.C.); (T.T.); (R.P.); (E.P.)
| | - Andrea Calciati
- Department of Neuroscience—Ophthalmology, University of Padova, 35128 Padova, Italy; (L.F.); (A.C.); (T.T.); (R.P.); (E.P.)
| | - Tommaso Torresin
- Department of Neuroscience—Ophthalmology, University of Padova, 35128 Padova, Italy; (L.F.); (A.C.); (T.T.); (R.P.); (E.P.)
| | | | - Raffaele Parrozzani
- Department of Neuroscience—Ophthalmology, University of Padova, 35128 Padova, Italy; (L.F.); (A.C.); (T.T.); (R.P.); (E.P.)
| | - Elisabetta Pilotto
- Department of Neuroscience—Ophthalmology, University of Padova, 35128 Padova, Italy; (L.F.); (A.C.); (T.T.); (R.P.); (E.P.)
| | - Edoardo Midena
- Department of Neuroscience—Ophthalmology, University of Padova, 35128 Padova, Italy; (L.F.); (A.C.); (T.T.); (R.P.); (E.P.)
- IRCCS—Fondazione Bietti, 00120 Rome, Italy;
- Correspondence: ; Tel.: +39-049-821-2110
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Bougatsou P, Panagiotopoulou EK, Gkika M, Dardabounis D, Konstantinidis A, Sideroudi H, Perente I, Labiris G. Comparison of Subthreshold 532 nm Diode Micropulse Laser with Conventional Laser Photocoagulation in the Treatment of Non-Centre Involved Clinically Significant Diabetic Macular Edema. ACTA MEDICA (HRADEC KRÁLOVÉ) 2021; 63:25-30. [PMID: 32422113 DOI: 10.14712/18059694.2020.12] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
BACKGROUND The aim of the study was to investigate the effect of the 532 nm (green) diode subthreshold micropulse laser (SML) in the treatment of non-centre involved clinically significant macular edema (CSME) in comparison to the conventional laser photocoagulation (CLP). METHODS A total of 60 eyes of patients diagnosed with non-centre involved CSME were randomly divided into two groups. SML photocoagulation was performed in the first group (G1), while CLP in the second one (G2). Central macular thickness (CMT) and best corrected visual acuity (BCVA) were measured prior to treatment and at 3 and 6 months after intervention. RESULTS G1 participants had significantly better CMT at 6 months after laser application (p = 0.04) compared to G2. Additionally, CMT in both groups was significantly lower 6 months after laser application in comparison to baseline values (G1: p < 0.001, G2: p = 0.002). Moreover, significant improvement was detected 6 months after SML in G1 regarding BCVA compared to values before laser treatment (p = 0.001). CONCLUSION SML was more effective than CLP in reducing CMT and improving BCVA in patients with non-centre involved CSME. Therefore, it seems that SML can be a good substitute for CLP in DME treatment if confirmed in future studies.
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Affiliation(s)
- Panagiota Bougatsou
- Department of Ophthalmology, University Hospital of Alexandroupolis, Dragana, Alexandroupolis, Greece
| | | | - Maria Gkika
- Department of Ophthalmology, University Hospital of Alexandroupolis, Dragana, Alexandroupolis, Greece
| | - Doukas Dardabounis
- Department of Ophthalmology, University Hospital of Alexandroupolis, Dragana, Alexandroupolis, Greece
| | - Aristeidis Konstantinidis
- Department of Ophthalmology, University Hospital of Alexandroupolis, Dragana, Alexandroupolis, Greece
| | - Haris Sideroudi
- Department of Ophthalmology, University Hospital of Alexandroupolis, Dragana, Alexandroupolis, Greece
| | - Irfan Perente
- Department of Ophthalmology, University Hospital of Alexandroupolis, Dragana, Alexandroupolis, Greece
| | - Georgios Labiris
- Department of Ophthalmology, University Hospital of Alexandroupolis, Dragana, Alexandroupolis, Greece
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Valera-Cornejo DA, García-Roa M, Quiroz-Mendoza J, Arias-Gómez A, Ramírez-Neria P, Villalpando-Gómez Y, Romero-Morales V, García-Franco R. Micropulse laser in patients with refractory and treatment-naïve center-involved diabetic macular edema: short terms visual and anatomic outcomes. Ther Adv Ophthalmol 2021; 13:2515841420979112. [PMID: 33521517 PMCID: PMC7818006 DOI: 10.1177/2515841420979112] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2020] [Accepted: 11/12/2020] [Indexed: 12/28/2022] Open
Abstract
Purpose: The purpose of the study is to describe visual and anatomic outcomes of
5774nm micropulse laser photocoagulation in eyes with either treatment-naïve
or refractory diabetic macular edema (DME) at 3 months. Methods: This was a prospective case series that recruited 23 consecutive patients (33
eyes) with center-involved DME that was either treatment-naïve or had not
responded to prior treatment. Micropulse therapy was performed with the Easy
Ret 577 (Quantel Medical, Cournon d’Auvergne, France) diode laser in a
high-density manner in eyes with treatment-naïve or refractory DME. The
primary outcome was the change of best-corrected visual acuity (BCVA;
logMAR) at 1 and 3 months. Secondary outcomes were changes in the central
macular thickness (CMT), thickness area, macular volume, and macular
capillary leakage at 1 and 3 months. Results: There were no significant changes in BCVA at 3 months, with mean ± standard
deviation (SD) of −0.08 ± 0.01 (p = 0.228)
and + 0.01 ± 0.01 (p = 0.969) for treatment-naïve and
refractory groups, respectively. The change in CMT at 3 months was
statistically but not clinically significant in the treatment-naïve group
only (mean ± SD; –30 ± 130 µm; p = 0.011). The macular
volume and area thickness change were not statistically significant
(p = 0.173 and p = 0.148 for macular
volume and area thickness, respectively) in the treatment-naïve group. There
was no difference concerning the leakage area in both groups. No adverse
events were reported. Conclusion: We concluded that micropulse 577nm laser therapy maintained the visual acuity
and macular thickness at 3 months in both treatment-naïve and refractory
DME.
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Affiliation(s)
| | - Marlon García-Roa
- Retina department, Instituto Mexicano de Oftalmología I.A.P., Santiago De Querétaro, Querétaro, México
| | - Jaime Quiroz-Mendoza
- Retina department, Instituto Mexicano de Oftalmología I.A.P., Santiago De Querétaro, Querétaro, México
| | - Alejandro Arias-Gómez
- Retina department, Instituto Mexicano de Oftalmología I.A.P., Santiago De Querétaro, Querétaro, México
| | - Paulina Ramírez-Neria
- Retina department, Instituto Mexicano de Oftalmología I.A.P., Santiago De Querétaro, Querétaro, México
| | - Yolanda Villalpando-Gómez
- Retina department, Instituto Mexicano de Oftalmología I.A.P., Santiago De Querétaro, Querétaro, México
| | - Veronica Romero-Morales
- Retina department, Instituto Mexicano de Oftalmología I.A.P., Santiago De Querétaro, Querétaro, México
| | - Renata García-Franco
- Retina department, Instituto Mexicano de Oftalmología I.A.P., Santiago De Querétaro, Querétaro, México
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Li ZJ, Xiao JH, Zeng P, Zeng R, Gao X, Zhang YC, Lan YQ. Optical coherence tomography angiography assessment of 577 nm laser effect on severe non-proliferative diabetic retinopathy with diabetic macular edema. Int J Ophthalmol 2020; 13:1257-1265. [PMID: 32821680 DOI: 10.18240/ijo.2020.08.12] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2019] [Accepted: 09/23/2019] [Indexed: 01/02/2023] Open
Abstract
AIM To quantitatively evaluate the effect of the combined use of 577-nm subthreshold micropulse macular laser (SML) and multi-point mode pan retinal laser photocoagulation (PRP) on severe non-proliferative diabetic retinopathy (NPDR) with central-involved diabetic macular edema (CIDME) using optical coherence tomography angiography (OCTA). METHODS In this observational clinical study, 86 eyes of 86 NPDR patients with CIDME who underwent SML and PRP treatment were included. Images were obtained 1d before laser and post-laser (1d, 1wk, 1, 3, and 6mo) using AngioVue software 2.0. Best corrected visual acuity (BCVA, LogMAR), foveal avascular zone area (FAZ), choriocapillary flow area (ChF), parafoveal vessel density (PVD), capillary density inside disc (CDD), peripapillary capillary density (PCD), macular ganglion cell complex thickness (mGCCT), central macular thickness (CMT), and subfoveal choroidal thickness (ChT) were compared between pre- and post-laser treatment. RESULTS BCVA remained stable during 6mo post-laser therapy (pre-laser vs 6mo post-laser: 0.53±0.21 vs 0.5±0.15, P>0.05). PVD, ChF, ChT, CMT, and mGCCT significantly increased 1d post-laser therapy [pre-laser vs 1d post-laser: superficial PVD (%), 40.51±3.42 vs 42.43±4.68; deep PVD (%), 42.66±3.67 vs 44.78±4.52; ChF, 1.72±0.21 vs 1.9±0.12 mm2; ChT, 302.45±69.74 vs 319.38±70.93 µm; CMT, 301.65±110.78 vs 320.86±105.62 µm; mGCCT, 105.71±10.72 vs 115.46±9.64 µm; P<0.05]. However, PVD, ChF and ChT decreased to less than baseline level at 6mo post-laser therapy (pre-laser vs 6mo post-laser: superficial PVD (%), 40.51±3.42 vs 36.32±4.19; deep PVD (%), 42.66±3.67 vs 38.76±3.74; ChF, 1.72±0.21 vs 1.62±0.09 mm2; ChT, 302.45±69.74 vs 289.61±67.55 µm; P<0.05), whereas CMT and mGCCT decreased to baseline level at 6mo post-laser therapy (CMT, 301.65±110.78 vs 297.77±90.23 µm; mGCCT, 105.71±10.72 vs 107.05±11.81 µm; P>0.05). Moreover, FAZ continuously increased while CDD and PCD continuously decreased in 6mo after laser therapy. CMT and ChT had a significant positive correlation with ChF and PVD in most post-laser stages. CONCLUSION During a 6-month follow-up period after combined use of SML and PRP therapy, BCVA remained stable and there was a decreased trend in macular edema. Blood flow increased at 1d post-laser therapy and reduced at 6mo post-laser therapy.
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Affiliation(s)
- Zi-Jing Li
- Department of Ophthalmology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou 510000, Guangdong Province, China.,Guangdong Provincial Key Laboratory of Malignant Tumor Epigenetics and Gene Regulation, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou 510000, Guangdong Province, China
| | - Jian-Hui Xiao
- Department of Ophthalmology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou 510000, Guangdong Province, China.,Guangdong Provincial Key Laboratory of Malignant Tumor Epigenetics and Gene Regulation, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou 510000, Guangdong Province, China
| | - Peng Zeng
- Department of Ophthalmology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou 510000, Guangdong Province, China
| | - Rui Zeng
- Department of Ophthalmology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou 510000, Guangdong Province, China.,Guangdong Provincial Key Laboratory of Malignant Tumor Epigenetics and Gene Regulation, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou 510000, Guangdong Province, China
| | - Xiang Gao
- Department of Ophthalmology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou 510000, Guangdong Province, China.,Guangdong Provincial Key Laboratory of Malignant Tumor Epigenetics and Gene Regulation, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou 510000, Guangdong Province, China
| | - Yi-Chi Zhang
- Department of Ophthalmology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou 510000, Guangdong Province, China.,Guangdong Provincial Key Laboratory of Malignant Tumor Epigenetics and Gene Regulation, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou 510000, Guangdong Province, China
| | - Yu-Qing Lan
- Department of Ophthalmology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou 510000, Guangdong Province, China.,Guangdong Provincial Key Laboratory of Malignant Tumor Epigenetics and Gene Regulation, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou 510000, Guangdong Province, China
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Gavrilova NA, Borzenok SA, Zaletaev DV, Solomin VA, Gadzhieva NS, Tishchenko OE, Komova OU, Zinov'eva AV. Molecular genetic mechanisms of influence of laser radiation with 577 nm wavelength in a microimpulse mode on the condition of the retina. Exp Eye Res 2019; 185:107650. [PMID: 31075223 DOI: 10.1016/j.exer.2019.04.018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2018] [Revised: 04/15/2019] [Accepted: 04/16/2019] [Indexed: 10/26/2022]
Abstract
THE AIM OF THE STUDY was to investigate the molecular genetic mechanisms of the influence of laser radiation with 577 nm wavelength in a microimpulse mode on the retina in the experimental conditions after the intravitreal injection of VEGF. MATERIALS AND METHODS The study was performed on 4-5 week-old male mice of the line C57BL/6J. The animals were divided into 4 groups of 5 mice in each group, one eye was excremental, the contralateral eye remained intact. In the first group, intravitreal injection of PBS was performed; in the second group, intravitreal injection of 50 ng/ml of recombinant VEGF165 in 2 μL of phosphate-buffered saline (PBS) was performed; in the third and fourth groups, a day after the intravitreal injection of recombinant VEGF165, laser radiation with wavelength 577 nm was applied in the micropulse and continuous modes, respectively. Tissue samples (neuroepithelium, pigment epithelium) for the microarray transcription analysis in the animals from group 1 and 2 were taken 2 days after the injection of PBS and VEGF, in the animals from group 3 and 4 - a day after the retina was exposed to laser radiation. RESULTS AND CONCLUSION Molecular genetic mechanisms of the influence of laser radiation with wavelength 577 nm in a microimpulse mode on the retina in experimental conditions were studied and the genes that significantly changed the level of expression (the genes that take part in the regulation of neoangiogenesis, structural cell functions, processes of cells proliferation, transcription, differentiation, transmembrane transport, signaling, synaptic transmission, etc.) were identified.
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Affiliation(s)
- Natalya A Gavrilova
- The A.I. Evdokimov Моscow State University of Medicine and Dentistry of the Ministry of Healthcare the Russian Federation, 127473, 20/1 Delegatskaya Str., Moscow, Russia.
| | - Sergey A Borzenok
- The A.I. Evdokimov Моscow State University of Medicine and Dentistry of the Ministry of Healthcare the Russian Federation, 127473, 20/1 Delegatskaya Str., Moscow, Russia; The S. Fyodorov Eye Microsurgery Federal State Institution, 127486, 59a Beskudnikovskiy Boulevard, Moscow, Russia
| | - Dmitri V Zaletaev
- I.M. Sechenov First Moscow State Medical University, Moscow, 119991, 8/2 Trubetskaya Str., Moscow, Russia; Research Centre for Medical Genetics, Russian Academy of Sciences, Moscow, 115522, 1 Moscvorechie, Moscow, Russia
| | - Vladislav A Solomin
- The S. Fyodorov Eye Microsurgery Federal State Institution, 127486, 59a Beskudnikovskiy Boulevard, Moscow, Russia
| | - Nuriya S Gadzhieva
- The A.I. Evdokimov Моscow State University of Medicine and Dentistry of the Ministry of Healthcare the Russian Federation, 127473, 20/1 Delegatskaya Str., Moscow, Russia
| | - Olga E Tishchenko
- The A.I. Evdokimov Моscow State University of Medicine and Dentistry of the Ministry of Healthcare the Russian Federation, 127473, 20/1 Delegatskaya Str., Moscow, Russia
| | - Olga U Komova
- The A.I. Evdokimov Моscow State University of Medicine and Dentistry of the Ministry of Healthcare the Russian Federation, 127473, 20/1 Delegatskaya Str., Moscow, Russia
| | - Aleksandra V Zinov'eva
- The A.I. Evdokimov Моscow State University of Medicine and Dentistry of the Ministry of Healthcare the Russian Federation, 127473, 20/1 Delegatskaya Str., Moscow, Russia
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9
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Elhamid AHA. Combined Intravitreal Dexamethasone Implant And Micropulse Yellow Laser For Treatment Of Anti-VEGF Resistant Diabetic Macular Edema. Open Ophthalmol J 2017; 11:164-172. [PMID: 28839510 PMCID: PMC5543696 DOI: 10.2174/1874364101711010164] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2017] [Revised: 05/16/2017] [Accepted: 06/07/2017] [Indexed: 01/20/2023] Open
Abstract
Purpose: To report the efficacy and safety of combined intravitreal dexamethasone implant and micropulse laser for anti-VEGF resistant diabetic macular edema. Patients and Methods: Prospective, non-controlled study that was conducted for twenty eyes with center-involved diabetic macular edema not responding to anti-VEGF therapy. Ozurdex intravitreal implant was injected to all eyes with subsequent micropulse yellow laser one month after the injection. All eyes were followed up after one, three, four, six, nine and twelve months. The primary outcome measure is the change in best corrected visual acuity (BCVA) after one year and secondary outcome measures are central macular thickness (CMT) change and safety of both dexamethasone implant and micropulse laser. Reinjection was done for those eyes with recurrent edema. Results: The mean age was 58.8 ±7.94 years. The mean BCVA was 0.6± 0.14, 0.57 ±0.12, 0.51±0.15, 0.59±0.12, 0.6± 0.12 and 0.59±0.14 after one, three, four, six, nine and twelve months in comparison to 0.45± 0.14 as initial BCVA [SS,P<0.05]. The CMT was 302.5±30.01, 330.6±20.24, 357.6±32.15, 285.4±19.95, 292.9±25.07 and 285.2±14.99 after one ,three, four ,six , nine and twelve months µm in comparison to initial CMT of 420.7 ±38.74µm [HS, P<0.01]. Cataract occurred in 6 eyes from 14 phakic eyes (42.8%). Transient ocular hypertension occurred in 6 eyes (30%). Reinjection was done for eight eyes (40%). Conclusion: Intravitreal dexamethasone implant and micropulse laser are both effective and safe treatment options for anti-VEGF resistant diabetic macular edema.
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