The value of transcutaneous electroneurostimulation in reducing the effective volume of retinal laser photocoagulation in patients with diabetic retinopathy

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Abstract

Background: Diabetic retinopathy is one of the most severe and late vascular complications of diabetes mellitus and is one of the leading causes of blindness and low vision worldwide. Laser photocoagulation is an effective and proven treatment for this disease; however, it carries certain risks and side effects. In this regard, it is important to identify medical technologies that allow reducing the volume of laser treatment.

AIM: To evaluate the safety and efficacy of transcutaneous electrical nerve stimulation (TENS) for reducing the effective volume of retinal laser photocoagulation in patients with preproliferative diabetic retinopathy.

Methods: An open-label prospective randomized controlled clinical trial included 89 patients with preproliferative diabetic retinopathy who were divided into two groups: the study group (43 patients) underwent retinal laser photocoagulation on the day after a course of TENS; the control group (46 patients) underwent laser photocoagulation alone. Ophthalmological examination was performed before treatment and at 2, 4 weeks, and 3 months.

Results: In the study group of patients who had received TENS, there were significantly fewer laser burns and the applied photocoagulation power was reduced. At all follow-up time points, patients in both groups showed comparable and statistically significant improvement in best-corrected visual acuity and reduction in central retinal thickness due to decreased diffuse edema. Differences were noted only in electrophysiological parameters after TENS at 3 months.

Conclusion: A course of TENS with individually adjusted parameters (based on the Kerdo index) in patients with preproliferative diabetic retinopathy is effective as a preoperative preparatory step for retinal laser photocoagulation, significantly reducing the effective volume of laser treatment, as evidenced by a reduction in both power (by 28%) and the number of laser burns (by 5%) compared with the control group. The same therapeutic effect in the study group was achieved with fewer and less powerful laser burns.

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About the authors

Oleg I. Borzunov

Ural State Medical University

Author for correspondence.
Email: borzunov.o.i@yandex.ru
ORCID iD: 0000-0001-6046-8607
SPIN-code: 6095-2309

MD, Dr. Sci. (Medicine), Assistant Professor

Russian Federation, Yekaterinburg

Andrei A. Fedorov

Ural State Medical University; Yekaterinburg Medical Research Center for Prophylaxis and Health Protection in Industrial Workers

Email: fedorov@ymrc.ru
ORCID iD: 0000-0002-9695-2959
SPIN-code: 9728-8397

MD, Dr. Sci. (Medicine), Professor

Russian Federation, Yekaterinburg; Yekaterinburg

Natalia S. Borzunova

Ural State Medical University

Email: masyaborzunova@yandex.ru
ORCID iD: 0000-0002-4538-4656
SPIN-code: 3443-2870

MD, Cand. Sci. (Medicine), Assistant Professor

Russian Federation, Yekaterinburg

Oleg V. Remizov

North Ossetian State Medical Academy

Email: sogma@minzdrav.alania.gov.ru
ORCID iD: 0000-0003-4175-5365
SPIN-code: 4375-8105

MD, Dr. Sci. (Medicine), Professor

Russian Federation, Vladikavkaz

Agnessa S. Kaisinova

North Caucasian Federal Scientific and Clinical Center

Email: zamoms@skfmba.ru
ORCID iD: 0000-0003-1199-3303
SPIN-code: 6552-9684

MD, Dr. Sci. (Medicine), Professor

Russian Federation, Yessentuki

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СМИ зарегистрировано Федеральной службой по надзору в сфере связи, информационных технологий и массовых коммуникаций (Роскомнадзор).
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