Sub-threshold micro-pulse diode laser treatment in diabetic macular edema： a Meta-analysis of randomized controlled trials  

作　　者：Gang Qiao Hai-Ke Guo Yan Dai Xiao-Li Wang Qian-Li Meng Hui Li Xiang-Hui Chen Zhong-Lun Chen 

机构地区：[1]Southern Medical University, Guangzhou 510515,Guangdong Province, China [2]Department of Ophthalmology, Guangdong General Hospital Affiliated to Southern Medical University, Guangzhou 510515, Guangdong Province, China [3]Mianyang Central Hospital, Mianyang 621000, Sichuan Province, China

出　　处：《International Journal of Ophthalmology(English edition)》2016年第7期1020-1027,共8页国际眼科杂志（英文版）

摘　　要：AIM：To examine possible differences in clinical outcomes between sub-threshold micro-pulse diode laser photocoagulation（SDM） and traditional modified Early Treatment Diabetic Retinopathy Study（mETDRS）treatment protocol in diabetic macuiar edema（DME）.METHODS：A comprehensive literature search using the Cochrane Collaboration methodology to identify RCTs comparing SDM with mETDRS for DME.The participants were type Ⅰ or type Ⅱ diabetes mellitus with clinically significant macuiar edema treated by SDM from previously reported randomized controlled trials（RCTs）.The primary outcome measures were the changes in the best corrected visual acuity（BCVA） and the central macuiar thickness（CMT） as measured by optical coherence tomography（OCT）.The secondary outcomes were the contrast sensitivity and the damages of the retina.RESULTS：Seven studies were identified and analyzed for comparing SDM（215 eyes） with mETDRS（210 eyes）for DME.There were no statistical differences in the BCVA after treatment between the SDM and mETDRS based on the follow-up：3mo（MD,-0.02;95% Cl,-0.12 to 0.09;P=0.77）,6mo（MD,-0.02;95% Cl,-0.12 to 0.09;P=0.75）,12mo（MD,-0.05;95% Cl,-0.17 to 0.07;P=0.40）.Likewise,there were no statistical differences in the CMT after treatment between the SDM and mETDRS in 3mo（MD,-9.92;95% Cl,-28.69 to 8.85;P=0.30）,6mo（MD,-11.37;95% Cl,-29.65 to 6.91;P=0.22）,12mo（MD,8.44;95% Cl,-29.89 to 46.77;P=0.67）.Three RCTs suggested that SDM laser results in good preservation of contrast sensitivity as mETDRS,in two different followup evaluations：3mo（MD,0.05;95% Cl,0 to 0.09;P=0.04） and 6mo（MD,0.02;95% Cl,-0.10 to 0.14;P=0.78）.Two RCTs showed that the SDM laser treatment did less retinal damage than that mETDRS did（OR,0.05;95% Cl,0.02 to 0.13;P〈0.01）.CONCLUSION：SDM laser photocoagulation shows an equally good effect on visual acuity,contrast sensitivity,and reduction of DME as compared to conventional mETDRS protocol with less retinal damage.AIM：To examine possible differences in clinical outcomes between sub-threshold micro-pulse diode laser photocoagulation（SDM） and traditional modified Early Treatment Diabetic Retinopathy Study（mETDRS）treatment protocol in diabetic macuiar edema（DME）.METHODS：A comprehensive literature search using the Cochrane Collaboration methodology to identify RCTs comparing SDM with mETDRS for DME.The participants were type Ⅰ or type Ⅱ diabetes mellitus with clinically significant macuiar edema treated by SDM from previously reported randomized controlled trials（RCTs）.The primary outcome measures were the changes in the best corrected visual acuity（BCVA） and the central macuiar thickness（CMT） as measured by optical coherence tomography（OCT）.The secondary outcomes were the contrast sensitivity and the damages of the retina.RESULTS：Seven studies were identified and analyzed for comparing SDM（215 eyes） with mETDRS（210 eyes）for DME.There were no statistical differences in the BCVA after treatment between the SDM and mETDRS based on the follow-up：3mo（MD,-0.02;95% Cl,-0.12 to 0.09;P=0.77）,6mo（MD,-0.02;95% Cl,-0.12 to 0.09;P=0.75）,12mo（MD,-0.05;95% Cl,-0.17 to 0.07;P=0.40）.Likewise,there were no statistical differences in the CMT after treatment between the SDM and mETDRS in 3mo（MD,-9.92;95% Cl,-28.69 to 8.85;P=0.30）,6mo（MD,-11.37;95% Cl,-29.65 to 6.91;P=0.22）,12mo（MD,8.44;95% Cl,-29.89 to 46.77;P=0.67）.Three RCTs suggested that SDM laser results in good preservation of contrast sensitivity as mETDRS,in two different followup evaluations：3mo（MD,0.05;95% Cl,0 to 0.09;P=0.04） and 6mo（MD,0.02;95% Cl,-0.10 to 0.14;P=0.78）.Two RCTs showed that the SDM laser treatment did less retinal damage than that mETDRS did（OR,0.05;95% Cl,0.02 to 0.13;P〈0.01）.CONCLUSION：SDM laser photocoagulation shows an equally good effect on visual acuity,contrast sensitivity,and reduction of DME as compared to conventional mETDRS protocol with less retinal damage.

关 键 词：sub-threshold laser photocoagulation diabetic macular edema 

分 类 号：R587.2[医药卫生—内分泌] R779.63[医药卫生—内科学]