Factors Influencing Threshold Energy in Subthreshold Photocoagulation for Diabetic Macular Edema

Hirotsugu Takashina,1 Akira Watanabe,2 Koji Komatsu,1 Tadashi Nakano2 1Department of Ophthalmology, Tokyo Rosai Hospital, Tokyo, Japan; 2Department of Ophthalmology, The Jikei University School of Medicine, Tokyo, JapanCorrespondence: Hirotsugu TakashinaDepartment of Ophthalmology, Tokyo Rosai Hospi...

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Autores principales:	Takashina H, Watanabe A, Komatsu K, Nakano T
Formato:	article
Lenguaje:	EN
Publicado:	Dove Medical Press 2021
Materias:	diabetic macular edema subthreshold photocoagulation panretinal photocoagulation vitrectomy cataract surgery Ophthalmology RE1-994
Acceso en línea:	https://doaj.org/article/2ab33d023bfd4d0da164fc20cb2e089d
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spelling	oai:doaj.org-article:2ab33d023bfd4d0da164fc20cb2e089d2021-12-02T15:20:04ZFactors Influencing Threshold Energy in Subthreshold Photocoagulation for Diabetic Macular Edema1177-5483https://doaj.org/article/2ab33d023bfd4d0da164fc20cb2e089d2021-05-01T00:00:00Zhttps://www.dovepress.com/factors-influencing-threshold-energy-in-subthreshold-photocoagulation--peer-reviewed-fulltext-article-OPTHhttps://doaj.org/toc/1177-5483Hirotsugu Takashina,1 Akira Watanabe,2 Koji Komatsu,1 Tadashi Nakano2 1Department of Ophthalmology, Tokyo Rosai Hospital, Tokyo, Japan; 2Department of Ophthalmology, The Jikei University School of Medicine, Tokyo, JapanCorrespondence: Hirotsugu TakashinaDepartment of Ophthalmology, Tokyo Rosai Hospital, 4-13-21 Omori-Minami, Ota-ku, Tokyo, 143-0013, Japan, Tel +81-3-3742-7301 ext 8116Fax +81-3-3744-9310Email two-shina@s7.dion.ne.jpBackground: Subthreshold photocoagulation is one of the treatments for diabetic macular edema. However, the range of adequate laser energy that can be used for subthreshold photocoagulation is very restricted. Therefore, determination of the titration settings for the threshold energy is an essential part of the subthreshold-photocoagulation procedure. This study examined factors influencing the threshold energy used in subthreshold photocoagulation for diabetic macular edema.Methods: For 20 consecutive cases (29 eyes) who had received treatment using Endpoint Management (EpM) between April 2019 and June 2020 for persistent diabetic macular edema after completion of panretinal photocoagulation, multiple regression analysis was used to examine factors influencing threshold energy.Results: Analysis evaluating all the surgical procedures (n=150) determined there was statistical significance for a history of vitrectomy and cataract surgery, central macular thickness, interval from completion of panretinal photocoagulation, superior 6 mm subfield, and nasal 6 mm subfield. Further analysis examined surgical procedures that had been done in patients with a history of vitrectomy and cataract surgery (n=116). This analysis showed that central macular thickness, axial length, interval from completion of panretinal photocoagulation, and HbA1c were all statistically significant factors.Conclusion: Threshold energy for diabetic macular edema was significantly influenced by a history of vitrectomy and cataract surgery, central macular thickness, and interval between the completion of panretinal photocoagulation and initial EpM. Transparency of ocular media and intraocular inflammation were speculated to be associated with these results.Keywords: diabetic macular edema, subthreshold photocoagulation, panretinal photocoagulation, vitrectomy, cataract surgeryTakashina HWatanabe AKomatsu KNakano TDove Medical Pressarticlediabetic macular edemasubthreshold photocoagulationpanretinal photocoagulationvitrectomycataract surgeryOphthalmologyRE1-994ENClinical Ophthalmology, Vol Volume 15, Pp 1827-1830 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	diabetic macular edema subthreshold photocoagulation panretinal photocoagulation vitrectomy cataract surgery Ophthalmology RE1-994
spellingShingle	diabetic macular edema subthreshold photocoagulation panretinal photocoagulation vitrectomy cataract surgery Ophthalmology RE1-994 Takashina H Watanabe A Komatsu K Nakano T Factors Influencing Threshold Energy in Subthreshold Photocoagulation for Diabetic Macular Edema
description	Hirotsugu Takashina,1 Akira Watanabe,2 Koji Komatsu,1 Tadashi Nakano2 1Department of Ophthalmology, Tokyo Rosai Hospital, Tokyo, Japan; 2Department of Ophthalmology, The Jikei University School of Medicine, Tokyo, JapanCorrespondence: Hirotsugu TakashinaDepartment of Ophthalmology, Tokyo Rosai Hospital, 4-13-21 Omori-Minami, Ota-ku, Tokyo, 143-0013, Japan, Tel +81-3-3742-7301 ext 8116Fax +81-3-3744-9310Email two-shina@s7.dion.ne.jpBackground: Subthreshold photocoagulation is one of the treatments for diabetic macular edema. However, the range of adequate laser energy that can be used for subthreshold photocoagulation is very restricted. Therefore, determination of the titration settings for the threshold energy is an essential part of the subthreshold-photocoagulation procedure. This study examined factors influencing the threshold energy used in subthreshold photocoagulation for diabetic macular edema.Methods: For 20 consecutive cases (29 eyes) who had received treatment using Endpoint Management (EpM) between April 2019 and June 2020 for persistent diabetic macular edema after completion of panretinal photocoagulation, multiple regression analysis was used to examine factors influencing threshold energy.Results: Analysis evaluating all the surgical procedures (n=150) determined there was statistical significance for a history of vitrectomy and cataract surgery, central macular thickness, interval from completion of panretinal photocoagulation, superior 6 mm subfield, and nasal 6 mm subfield. Further analysis examined surgical procedures that had been done in patients with a history of vitrectomy and cataract surgery (n=116). This analysis showed that central macular thickness, axial length, interval from completion of panretinal photocoagulation, and HbA1c were all statistically significant factors.Conclusion: Threshold energy for diabetic macular edema was significantly influenced by a history of vitrectomy and cataract surgery, central macular thickness, and interval between the completion of panretinal photocoagulation and initial EpM. Transparency of ocular media and intraocular inflammation were speculated to be associated with these results.Keywords: diabetic macular edema, subthreshold photocoagulation, panretinal photocoagulation, vitrectomy, cataract surgery
format	article
author	Takashina H Watanabe A Komatsu K Nakano T
author_facet	Takashina H Watanabe A Komatsu K Nakano T
author_sort	Takashina H
title	Factors Influencing Threshold Energy in Subthreshold Photocoagulation for Diabetic Macular Edema
title_short	Factors Influencing Threshold Energy in Subthreshold Photocoagulation for Diabetic Macular Edema
title_full	Factors Influencing Threshold Energy in Subthreshold Photocoagulation for Diabetic Macular Edema
title_fullStr	Factors Influencing Threshold Energy in Subthreshold Photocoagulation for Diabetic Macular Edema
title_full_unstemmed	Factors Influencing Threshold Energy in Subthreshold Photocoagulation for Diabetic Macular Edema
title_sort	factors influencing threshold energy in subthreshold photocoagulation for diabetic macular edema
publisher	Dove Medical Press
publishDate	2021
url	https://doaj.org/article/2ab33d023bfd4d0da164fc20cb2e089d
work_keys_str_mv	AT takashinah factorsinfluencingthresholdenergyinsubthresholdphotocoagulationfordiabeticmacularedema AT watanabea factorsinfluencingthresholdenergyinsubthresholdphotocoagulationfordiabeticmacularedema AT komatsuk factorsinfluencingthresholdenergyinsubthresholdphotocoagulationfordiabeticmacularedema AT nakanot factorsinfluencingthresholdenergyinsubthresholdphotocoagulationfordiabeticmacularedema
_version_	1718387437466550272

Factors Influencing Threshold Energy in Subthreshold Photocoagulation for Diabetic Macular Edema

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