In the JournalsPerspective

Study: Green, yellow laser treatment results similar in diabetic macular edema

Whether wavelength for yellow or green laser is chosen for treatment of diabetic macular edema, little clinical difference is seen between the two, according to a review of data.

Differences in visual acuity and OCT parameters for eyes assigned to sham injection plus prompt laser, ranibizumab plus prompt laser and prompt laser-only were analyzed in two randomized clinical trials.

Researchers used green or yellow wavelength at their own discretion.

Eyes in the sham injection plus prompt laser group, receiving green and yellow laser treatment, respectively, had a mean visual acuity letter score of +2.4 and +5.1 at 52 weeks (P = .06) and +2.4 and +6.0 at 104 weeks (P = .13). No differences in OCT thickness were evident.

There were also no meaningful differences in visual acuity and OCT thickness between the ranibizumab plus prompt laser and prompt laser-only groups at 1 and 2 years.

Disclosure: The authors have no relevant financial disclosures.

Whether wavelength for yellow or green laser is chosen for treatment of diabetic macular edema, little clinical difference is seen between the two, according to a review of data.

Differences in visual acuity and OCT parameters for eyes assigned to sham injection plus prompt laser, ranibizumab plus prompt laser and prompt laser-only were analyzed in two randomized clinical trials.

Researchers used green or yellow wavelength at their own discretion.

Eyes in the sham injection plus prompt laser group, receiving green and yellow laser treatment, respectively, had a mean visual acuity letter score of +2.4 and +5.1 at 52 weeks (P = .06) and +2.4 and +6.0 at 104 weeks (P = .13). No differences in OCT thickness were evident.

There were also no meaningful differences in visual acuity and OCT thickness between the ranibizumab plus prompt laser and prompt laser-only groups at 1 and 2 years.

Disclosure: The authors have no relevant financial disclosures.

    Perspective

    Treatment of diabetic macular edema remains vexing almost a half-century after the introduction of laser treatment, and nearly a decade after the advent of pharmacotherapy. In the OCT era, objective, quantifiable information is finally available to accurately assess the problem of DME and the effects of treatment. Using this technology and methodical clinical trial techniques, the Diabetic Retinopathy Clinical Research Network is systematically evaluating DME and its treatment, yielding incremental but important information to grade future DME therapy.

    This article “mines” a previous DRCRN study of combined focal/grid laser therapy and pharmacotherapy in order to significantly comment on the relative value of green versus yellow wavelength laser in DME treatment.

    The take-home message here is that either green or yellow laser remains appropriate for focal/grid DME treatment. While this is not going to substantially change current therapy, it does effectively “put to bed” one concern for treating physicians who must analyze a plethora of other variables in the difficult treatment of DME – and that is appreciated.

    • Robert E. Morris, MD, OSN Retina/Vitreous Section Board Member

    Disclosures: Morris has no relevant financial disclosures.