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Hamed N, Vander Woude L, Roohipourmoallai R, Ohning C, Regan KA, Iyer SSR. Effect of pattern scanning laser on macular thickness in diabetic retinopathy. Ther Adv Ophthalmol 2021; 13:25158414211035860. [PMID: 34409259 PMCID: PMC8366200 DOI: 10.1177/25158414211035860] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2020] [Accepted: 07/06/2021] [Indexed: 11/30/2022] Open
Abstract
Purpose: This study investigates the effect of pattern scanning laser (PASCAL) panretinal photocoagulation (PRP) on central macular thickness (CMT) and visual acuity (VA) in patients with proliferative diabetic retinopathy (PDR). Methods: This retrospective non-randomized comparative case series included 262 eyes (163 with macular edema) of 177 patients with PDR. Treatment was PRP alone (137), PRP + anti-vascular endothelial growth factor (VEGF) (69), PRP + focal laser (28), or all three (89). CMT and central macular volume 3 and 6 mm from fovea were analyzed before and 1, 3, and 6 months after PRP. Spot number was plotted against CMT, and linear regression analysis was performed. Results: For each treatment group and time point, there was a non-significant relationship between spot number and CMT. In eyes receiving all three treatment modalities, a significant negative relationship was found between spot number and 3-mm volume at 6 months (p = 0.04) and 6-mm volume at 1 month (p = 0.002) and 6 months (p = 0.011). There was no significant change in VA in any treatment group at the 6-month time point. Conclusion: PASCAL PRP ± focal laser or anti-VEGF was not associated with increased development of macular edema or change in VA. PASCAL PRP with focal laser and anti-VEGF may result in a decrease in macular edema.
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Affiliation(s)
- Nadine Hamed
- Department of Ophthalmology, College of Medicine, University of Florida, Gainesville, FL, USA
| | - Logan Vander Woude
- Department of Ophthalmology, College of Medicine, University of Florida, Gainesville, FL, USA
| | - Ramak Roohipourmoallai
- Department of Ophthalmology, College of Medicine, University of Florida, Gainesville, FL, USA
| | - Collin Ohning
- Department of Ophthalmology, College of Medicine, University of Florida, Gainesville, FL, USA
| | - Kathleen A Regan
- Department of Ophthalmology, College of Medicine, University of Florida, Gainesville, FL, USA
| | - Siva S R Iyer
- Associate Professor, Department of Ophthalmology, College of Medicine , University of Florida, 1600, SW Archer Road, Gainesville FL, 32610, USA
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Torres-Villaros H, Rey PA, Janicot L, Fajnkuchen F, Giocanti-Aurégan A. [Bilateral uveal effusion following ab externo panretinal photocoagulation diagnosed by ultrabiomicroscopy]. J Fr Ophtalmol 2021; 44:e455-e457. [PMID: 33965271 DOI: 10.1016/j.jfo.2020.08.034] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2020] [Accepted: 08/27/2020] [Indexed: 11/19/2022]
Affiliation(s)
- H Torres-Villaros
- Service d'ophtalmologie, centre hospitalier universitaire Avicenne-Paris 13, 125, rue de Stalingrad, 93000 Bobigny, France
| | - P-A Rey
- Service d'ophtalmologie, centre hospitalier universitaire Avicenne-Paris 13, 125, rue de Stalingrad, 93000 Bobigny, France
| | - L Janicot
- Service d'ophtalmologie, centre hospitalier universitaire Avicenne-Paris 13, 125, rue de Stalingrad, 93000 Bobigny, France
| | - F Fajnkuchen
- Service d'ophtalmologie, centre hospitalier universitaire Avicenne-Paris 13, 125, rue de Stalingrad, 93000 Bobigny, France; Centre ophtalmologique d'imagerie et de laser, 11, rue Antoine-Bourdelle, 75015 Paris, France
| | - A Giocanti-Aurégan
- Service d'ophtalmologie, centre hospitalier universitaire Avicenne-Paris 13, 125, rue de Stalingrad, 93000 Bobigny, France.
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Khalkhal E, Razzaghi M, Rostami-Nejad M, Rezaei-Tavirani M, Heidari Beigvand H, Rezaei Tavirani M. Evaluation of Laser Effects on the Human Body After Laser Therapy. J Lasers Med Sci 2020; 11:91-97. [PMID: 32099633 DOI: 10.15171/jlms.2020.15] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
Lasers have wide applications in the treatment and diagnosis of diseases and various medical fields. Laser therapy like the other methods has advantages and disadvantages. Some risks such as bleeding, pain, and infection are created after laser therapy. Explanation and evaluation of laser effects on cell function, tissue, and the body are the aims of this study. We reviewed papers available from 1986 to 2019 about the effects of lasers on cells and tissue. An online search of PubMed, Science Direct and Google scholar using such keywords as "laser", "cell", "tissue", "body" and "side effects" was performed. The laser photons are absorbed by chromophores, resulting in the target heating and localized damage. Laser irradiation alters cellular metabolism and cellular functions. These alterations may be accompanied by undesired side effects which can be monitored via metabolites level change in the body. Based on this finding, laser therapy may be associated with several side effects and complications; therefore, before treatment, the determination of laser types and their properties is necessary to avoid creating side effects. The advantages and disadvantages of the treatment type should be considered in order to choose the best treatment with the least side effects. The patients' awareness of possible side effects before treatment and also an effective follow-up and management of patients after action are two important points in laser therapy. Training curriculum definition should be determined for laser applicant qualifications in different medical fields.
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Affiliation(s)
- Ensieh Khalkhal
- Proteomics Research Center, Faculty of Paramedical Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Mohammadreza Razzaghi
- Laser Application in Medical Sciences Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Mohammad Rostami-Nejad
- Gastroenterology and Liver Diseases Research Center, Research Institute for Gastroenterology and Liver Diseases, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Majid Rezaei-Tavirani
- Firoozabadi Hospital, Faculty of Medicine, Iran University of Medical Sciences, Tehran, Iran
| | - Hazhir Heidari Beigvand
- Firoozabadi Hospital, Faculty of Medicine, Iran University of Medical Sciences, Tehran, Iran
| | - Mostafa Rezaei Tavirani
- Proteomics Research Center, Faculty of Paramedical Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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4
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Ye H, Yu M, Lu L, Jin C, Luo G. Electroretinogram evaluation for the treatment of proliferative diabetic retinopathy by short-pulse pattern scanning laser panretinal photocoagulation. Lasers Med Sci 2018. [PMID: 29542045 DOI: 10.1007/s10103-018-2474-0] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
Panretinal photocoagulation (PRP) is a standard method for proliferative diabetic retinopathy (PDR) treatment. However, conventional PRP usually significantly damages the retinal structure and vision. Retinal pattern scanning laser (PASCAL) photocoagulation has emerged as a new technique with fewer complications for the treatment of retinal disorders. This study compares the therapeutic effects of short-pulse PASCAL to conventional single-spot PRP for PDR. Fifty-two PDR patients (104 eyes) were randomly assigned into a short-pulse PASCAL-PRP treatment (SP) group and a conventional PRP treatment (TP) group. The best corrected visual acuity (BCVA) and full-field flash electroretinogram (ERG) data were evaluated before and after the two treatments. The BCVA data between before and after the PRP treatments did not show any significant difference. After the PRP treatment, the b-wave amplitude (b-A) in the dark-adapted 3.0 ERG (p = 0.0005) and the amplitude in the light-adapted 3.0 flicker ERG (p = 0.009) were significantly higher in the SP group compared with that of the TP group. In addition, after the PRP treatment, the a-wave implicit time (a-T) of light-adapted 3.0 ERG prolonged significantly in the TP group compared to the SP group. Compared with the parameters before the treatments, the a-A and b-A under dark-adapted 3.0 ERG and the b-A under the light-adapted 3.0 ERG in both TP and SP groups after the treatments decreased significantly (p < 0.05). Short-pulse PASCAL-PRP significantly attenuated partial vision damage compared to conventional PRP, although it still caused limited retinal injury and mild reduction in retinal function. These findings suggest that short-pulse PASCAL-PRP is a promising technique for PDR treatment.
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Affiliation(s)
- Haiyun Ye
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-Sen University, No. 54 South Xianlie Road, Guangzhou, Guangdong, 510060, China.,Department of Ophthalmology, Shanghai Children's Hospital, Shanghai Jiao Tong University, Shanghai, 200060, China
| | - Minzhong Yu
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-Sen University, No. 54 South Xianlie Road, Guangzhou, Guangdong, 510060, China.,Department of Ophthalmology, University Hospitals Cleveland Medical Center, Cleveland, OH, 44106, United States
| | - Lin Lu
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-Sen University, No. 54 South Xianlie Road, Guangzhou, Guangdong, 510060, China
| | - Chenjin Jin
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-Sen University, No. 54 South Xianlie Road, Guangzhou, Guangdong, 510060, China.
| | - Guangwei Luo
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-Sen University, No. 54 South Xianlie Road, Guangzhou, Guangdong, 510060, China.
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Çeliker H, Erdağı Bulut A, Şahin Ö. Comparison of Efficacy and Side Effects of Multispot Lasers and Conventional Lasers for Diabetic Retinopathy Treatment. Turk J Ophthalmol 2017; 47:34-41. [PMID: 28182169 PMCID: PMC5282539 DOI: 10.4274/tjo.75032] [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: 01/01/2016] [Accepted: 04/22/2016] [Indexed: 12/14/2022] Open
Abstract
Panretinal photocoagulation (PRP) is a standard treatment for proliferative diabetic retinopathy. Conventional laser (CL) therapy is performed in one or more sessions in single spot mode. Visual disabilities have been reported after treatment with CL, including central vision loss due to macular edema and peripheral visual field loss resulting from extensive inner retinal scarring. Multispot laser (MSL) photocoagulation has recently been introduced to clinical practice. Studies comparing PRP conducted with MSL and CL have reported that MSLs resulted in less retinal tissue damage and pain, and greater patient comfort compared to CL. The aim of this review was to compare the efficacy and side effects of MSLs and CLs for diabetic retinopathy treatment.
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Affiliation(s)
- Hande Çeliker
- Marmara University Faculty of Medicine, Department of Ophthalmology, İstanbul, Turkey
| | - Azer Erdağı Bulut
- Marmara University Faculty of Medicine, Department of Ophthalmology, İstanbul, Turkey
| | - Özlem Şahin
- Marmara University Faculty of Medicine, Department of Ophthalmology, İstanbul, Turkey
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6
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Yilmaz I, Perente I, Saracoglu B, Yazici AT, Taskapili M. Changes in pupil size following panretinal retinal photocoagulation: conventional laser vs pattern scan laser (PASCAL). Eye (Lond) 2016; 30:1359-1364. [PMID: 27391936 DOI: 10.1038/eye.2016.135] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2015] [Accepted: 05/05/2016] [Indexed: 11/09/2022] Open
Abstract
PurposeTo evaluate and compare the possible changes in pupil size subsequent to panretinal laser photocoagulation (PRP) via conventional laser and pattern scan laser (PASCAL).Patients and methodsForty eyes of 40 patients with diabetic retinopathy were included. 20 eyes had a PRP via conventional laser and formed Group 1. 20 eyes had a PRP via PASCAL laser and formed Group 2. The participants underwent standard ophthalmologic examination at baseline. Automated infrared pupillometry were performed at baseline and month 1.ResultsThe mean pupillary measurements (mm) for Group 1 (in the order photopic, mesopic, and scotopic conditions) were 2.88±0.34, 3.38±0.40, and 3.95±0.38, and changed to 3.64±0.42, 4.18±0.42, and 4.58±0.48, respectively. There was significant increase in pupil size at month 1 (P<0.001, P<0.001, and P<0.00, respectively). For Group 2, they were 2.90±0.38, 3.43±0.36, and 3.90±0.40, and changed to 3.18±0.42, 3.74±0.36, and 4.10±0.38, respectively. There was significant increase in pupil size at month 1 (P=0.018, P=0.014, and P=0.014, respectively). The pupil size increased significantly in both groups in all illumination conditions.ConclusıonWe have demonstrated via automated infrared pupillary measurements that PRP may significantly increase pupil size whether it is performed with conventional laser or PASCAL laser.
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Affiliation(s)
- I Yilmaz
- Retina Department, Beyoglu Eye Training and Research Hospital, Istanbul, Turkey
| | - I Perente
- Retina Department, Beyoglu Eye Training and Research Hospital, Istanbul, Turkey
| | - B Saracoglu
- Retina Department, Beyoglu Eye Training and Research Hospital, Istanbul, Turkey
| | - A T Yazici
- Retina Department, Beyoglu Eye Training and Research Hospital, Istanbul, Turkey
| | - M Taskapili
- Retina Department, Beyoglu Eye Training and Research Hospital, Istanbul, Turkey
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7
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Yilmaz I, Faiz M, Saracoglu B, Yazici AT. Changes in Pupil Size Following Panretinal and Focal/Grid Retinal Photocoagulation: Automatic Infrared Pupillometry Study. J Ocul Pharmacol Ther 2015; 32:172-7. [PMID: 26580579 DOI: 10.1089/jop.2015.0080] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
PURPOSE To evaluate possible changes in pupil size subsequent to panretinal and focal/grid laser photocoagulation. METHODS Sixty-four eyes of 64 participants were included. Thirty-two eyes with planned panretinal photocoagulation formed Group 1, and 32 eyes with planned focal retinal photocoagulation formed Group 2. The participants underwent full ophthalmologic examination at baseline. Automated infrared pupillometry was performed at baseline and month 1. RESULTS The mean pupillary measurements (in millimeters) for Group 1 (in order photopic, mesopic, scotopic) were 3.09 ± 0.69 mm, 3.66 ± 0.85 mm, and 3.87 ± 1.01 mm and changed to 3.34 ± 0.74 mm, 3.82 ± 0.92 mm, and 4.03 ± 1.02 mm. There was a significant increase in pupil size at month 1 (P = 0.001, P = 0.001, P = 0.003). For Group 2, they were 2.65 ± 0.87 mm, 3.08 ± 1.08 mm, and 3.18 ± 1.19 mm and changed to 2.92 ± 0.72 mm, 3.45 ± 0.76 mm, and 3.57 ± 0.88 mm. There was no significant difference in pupil size at month 1 (P = 0.151, P = 0.106, P = 0.095). CONCLUSION We have demonstrated through automated infrared pupillary measurements that panretinal laser photocoagulation may significantly influence pupil size and focal/grid laser photocoagulation may not.
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Affiliation(s)
- Ihsan Yilmaz
- Department of Ophthalmology, Beyoglu Eye Training and Research Hospital , Istanbul, Turkey
| | - Miray Faiz
- Department of Ophthalmology, Beyoglu Eye Training and Research Hospital , Istanbul, Turkey
| | - Basak Saracoglu
- Department of Ophthalmology, Beyoglu Eye Training and Research Hospital , Istanbul, Turkey
| | - Ahmet Taylan Yazici
- Department of Ophthalmology, Beyoglu Eye Training and Research Hospital , Istanbul, Turkey
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8
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Clarkson DM, Makhzoum O, Blackburn J. Determination of pulse profile characteristics of multi spot retinal photocoagulation lasers. Med Eng Phys 2015; 37:1027-31. [PMID: 26343225 DOI: 10.1016/j.medengphy.2015.07.009] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2015] [Revised: 07/15/2015] [Accepted: 07/21/2015] [Indexed: 11/27/2022]
Abstract
A system is described for determination of discrete pulse train characteristics of multi spot laser delivery systems for retinal photocoagulation. While photodiodes provide an ideal detection mechanism, measurement artifacts can potentially be introduced by the spatial pattern of the delivered beam relative to a discrete photodiode element. This problem was overcome by use of an integrating sphere to produce a uniform light field at the site of the photodiode detector. A basic current driven photodiode detection circuit incorporating an operational amplifier was used to generate a signal captured by a commercially available USB interface device at a rate of 10 kHz. Studies were undertaken of a Topcon Pascal Streamline laser system with output at a wavelength of 577 nm (yellow). This laser features the proprietary feature of 'Endpoint Management' ™ where pulses can be delivered as 100% of set energy levels with visible reaction on the retina and also at a reduced energy level to create potentially non visible but clinically effective lesions. Using the pulse train measurement device it was identified that the 'Endpoint Management' ™ delivery mode of pulses of lower energy was achieved by reducing the pulse duration of pulses for non-visible effect pulses while maintaining consistent beam power levels within the delivered pulse profile. The effect of eye geometry in determining safety and effectiveness of multi spot laser delivery for retinal photocoagulation is discussed.
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Affiliation(s)
- Douglas McG Clarkson
- Development and Quality Manager, Clinical Physics and Bioengineering, FM Building University Hospital, Coventry CV2 2DX, UK.
| | - Osama Makhzoum
- Associate Specialist, Department of Ophthalmology, University Hospital, Coventry CV2 2DX, UK
| | - John Blackburn
- Clinical Technologist, MEBS, University Hospital, Coventry CV2 2DX, UK
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Deschler EK, Sun JK, Silva PS. Side-effects and complications of laser treatment in diabetic retinal disease. Semin Ophthalmol 2015; 29:290-300. [PMID: 25325854 DOI: 10.3109/08820538.2014.959198] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
Laser treatment for diabetic retinopathy was the first intraocular treatment to provide a highly effective means for preventing visual loss in patients with diabetes. Although inherently destructive, laser treatment is remarkably effective in preventing visual loss and preserving vision long-term. This review will describe briefly the current techniques and discuss in detail the reported side-effects and potential complications of laser treatment of diabetic retinal disease.
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Affiliation(s)
- Emily K Deschler
- Beetham Eye Institute, Joslin Diabetes Center , Boston, Massachusetts , USA and
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10
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Changes in Central Macular Thickness following Single Session Multispot Panretinal Photocoagulation. J Ophthalmol 2015; 2015:529529. [PMID: 25694825 PMCID: PMC4324916 DOI: 10.1155/2015/529529] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2014] [Revised: 12/26/2014] [Accepted: 01/06/2015] [Indexed: 12/17/2022] Open
Abstract
Purpose. To determine changes in central subfield (CSF) macular thickness
and best corrected visual acuity (BCVA) following single session, multispot panretinal photocoagulation
(PRP). Methods. Forty eyes of 33 patients with newly diagnosed proliferative diabetic retinopathy
were treated with single session, 20-millisecond, multispot PRP. Changes in central macular thickness and BCVA
at 4- and 12-week follow-up were compared to baseline measurements. Results.
Each eye received a mean (SD) of 2,750 (686.7) laser spots. At 4-week follow-up, there was a statistically
significant 24.0 μm increase in mean CSF thickness (P = 0.001), with a 17.4 μm increase from baseline at 12-week follow-up (P = 0.002). Mean logMAR BCVA increased by 0.05 logMAR units (P = 0.03) at 4-week follow-up. At 12-week follow-up, BCVA had almost returned to normal with only an increase of 0.02 logMAR units compared to baseline (P = 0.39). Macular edema occurred in 2 eyes (5%) at 12-week follow-up. Conclusions.
Macular thickening occurs following single session, 20-millisecond, multispot PRP, with a corresponding, mild change
in BCVA. However, the incidence of macular edema appears to be low in these patients. Single session, 20-millisecond,
multispot PRP appears to be a safe treatment for patients with proliferative diabetic retinopathy.
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Konac E, Sonmez K, Bahcelioglu M, Kaplanoglu GT, Varol N, Sarac GN, Ozcan PY. Does Pattern Scan Laser (PASCAL) photocoagulation really induce less VEGF expression in murine retina than conventional laser treatment? Gene 2014; 549:156-60. [PMID: 25065920 DOI: 10.1016/j.gene.2014.07.062] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2014] [Revised: 07/21/2014] [Accepted: 07/23/2014] [Indexed: 11/17/2022]
Abstract
To investigate the differences in the mRNA and protein expression levels of vascular endothelial growth factor (VEGF) in murine retina between mice subjected to conventional laser (AG) and those subjected to Pattern Scan Laser (PASCAL) system. Male C57BL/6 mice were randomly assigned to one of three groups: Group 1 (G1) receiving retinal scatter laser photocoagulation using with AG photocoagulator (n=16), Group 2 (G2) receiving retinal scatter laser photocoagulation using with PASCAL (n=16) and Group 3 (G3) served as an untreated control group (n=6). Molecular and morphological analyses of VEGF were performed on days 1, 2 and 5 by ELISA, real-time PCR and immuno-histochemical analysis. In samples which underwent AG (G1), when compared with the control group (G3), VEGF mRNA level increased 2.4 folds on day 2, whereas it decreased on day 5 (p□0.001). In samples which underwent PASCAL (G2), on the other hand, VEGF mRNA level increased 1.8 folds on day 1 and 2.2 folds on day 5 when compared with the control group (G3). In samples which underwent AG (G1), when compared with the control group (G3), VEGF protein level increased significantly on day 2, whereas it decreased on day 5 (p□0.001). In group G2, the VEGF levels in the sensory retina significantly increased as compared to control groups at both 2 and 5 days after laser photocoagulation using PASCAL laser (p=0.012, both time points). The peak expressions of VEGF protein in samples which underwent PASCAL and conventional laser were found on day 5 and day 2 respectively. In retinas of PASCAL-treated mice, VEGF immunoreactivity gradually increased during the 5-day follow-up. However, in argon laser group, the strongest VEGF immunoreactivity was detected on day 2, then started to decrease on day 5. In summary, the expression of VEGF protein and mRNA gradually increase during a 5-day follow-up period in PASCAL-treated mouse eyes, whereas in AG group they reach their peak levels on the second day of follow-up and started decreasing after then. These results may also explain why the PASCAL system is less effective in regressing neovascularization in the clinic.
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Affiliation(s)
- Ece Konac
- Department of Medical Biology and Genetics, Faculty of Medicine, Gazi University, Besevler, Ankara, Turkey.
| | - Kenan Sonmez
- Ulucanlar Eye Research and Education Hospital, Ankara, Turkey
| | - Meltem Bahcelioglu
- Department of Anatomy, Faculty of Medicine, Gazi University, Besevler, Ankara, Turkey
| | - Gulnur Take Kaplanoglu
- Department of Histology and Embryology, Faculty of Medicine, Gazi University, Besevler, Ankara, Turkey
| | - Nuray Varol
- Department of Medical Biology and Genetics, Faculty of Medicine, Gazi University, Besevler, Ankara, Turkey
| | - Gulce Naz Sarac
- Department of Histology and Embryology, Faculty of Medicine, Gazi University, Besevler, Ankara, Turkey
| | - P Yasin Ozcan
- Ulucanlar Eye Research and Education Hospital, Ankara, Turkey
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Oh JH, Kim SW, Kwon SS, Oh J, Huh K. The change of macular thickness following single-session pattern scan laser panretinal photocoagulation for diabetic retinopathy. Graefes Arch Clin Exp Ophthalmol 2014; 253:57-63. [PMID: 24862300 DOI: 10.1007/s00417-014-2663-x] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2013] [Revised: 04/23/2014] [Accepted: 05/06/2014] [Indexed: 10/25/2022] Open
Abstract
PURPOSE To identify the incidence and risk factors of macular edema development following single-session pattern scan laser panretinal photocoagulation (PRP) for eyes with diabetic retinopathy. METHODS Medical records were reviewed in consecutive patients who underwent single-session PRP for diabetic retinopathy. The eyes with baseline central subfield retinal thickness (CRT) less than 300 μm were included. RESULTS Macular edema developed in 11 (8.5%) of 129 eyes 1 months after PRP. In the multivariate analysis, baseline CRT (μm) (odds ratio [OR] = 1.04, 95% confidence interval [CI] = 1.00-1.08, p = 0.048) and presence of intraretinal cystoid spaces or subretinal fluid on spectral-domain optical coherence tomography (SD-OCT) images (OR = 38.33; 95% CI = 1.36-1,083.14, p = 0.032) were significantly associated with macular edema development at 1-month visit. Macular edema developed in two (2.1%) of 97 eyes without cystoid spaces or subretinal fluid. The macular edema was spontaneously resolved in five (45.5%) of 11 cases at 3-month visit. CONCLUSIONS SD-OCT may be helpful in predicting the development of macular edema, although the macular edema rarely developed after single-session pattern scan laser PRP and was spontaneously resolved in many cases.
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Affiliation(s)
- Jong-Hyun Oh
- Department of Ophthalmology, Dongguk University Ilsan Hospital, Goyang, South Korea
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13
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Park YR, Jee D. Changes in peripapillary retinal nerve fiber layer thickness after pattern scanning laser photocoagulation in patients with diabetic retinopathy. KOREAN JOURNAL OF OPHTHALMOLOGY 2014; 28:220-5. [PMID: 24882955 PMCID: PMC4038727 DOI: 10.3341/kjo.2014.28.3.220] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2013] [Accepted: 09/23/2013] [Indexed: 11/23/2022] Open
Abstract
Purpose To examine the effects of panretinal photocoagulation (PRP) using a pattern scanning laser (PASCAL) system on the retinal nerve fiber layer (RNFL) thickness in patients with diabetic retinopathy. Methods This retrospective study included 105 eyes with diabetic retinopathy, which consisted of three groups: the PASCAL group that underwent PRP with the PASCAL method (33 eyes), the conventional group that underwent conventional PRP treatment (34 eyes), and the control group that did not receive PRP (38 eyes). The peripapillary RNFL thickness was measured by optical coherence tomography before, six months, and one year after PRP to evaluate the changes in peripapillary RNFL. Results The RNFL thickness in the PASCAL group did not show a significant difference after six months (average 3.7 times, p = 0.15) or one year after the PRP (average 3.7 times, p = 0.086), whereas that in the conventional group decreased significantly after six months (average 3.4 times, p < 0.001) and one year after PRP (average 3.4 times, p < 0.001). Conclusions The results of this study suggest that the PASCAL system may protect against RNFL loss by using less energy than conventional PRP.
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Affiliation(s)
- Yi-Ryeung Park
- Department of Ophthalmology and Visual Science, St. Vincent's Hospital, The Catholic University of Korea College of Medicine, Suwon, Korea
| | - Donghyun Jee
- Department of Ophthalmology and Visual Science, St. Vincent's Hospital, The Catholic University of Korea College of Medicine, Suwon, Korea
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Chhablani J, Kozak I, Barteselli G, El-Emam S. A novel navigated laser system brings new efficacy to the treatment of retinovascular disorders. Oman J Ophthalmol 2013; 6:18-22. [PMID: 23772120 PMCID: PMC3678191 DOI: 10.4103/0974-620x.111898] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
The laser photocoagulation is now treatment of choice for various retinovascular disorders. Conventional slit-lamp based laser delivery systems have many limitations including, questionable accuracy, need of contact lens with local anesthesia, and inadvertent damage to fovea. Navigated laser system, a fundus camera based laser delivery system with computer based laser planning and laser treatment without contact lens achieves improved patient compliance, improved accuracy, and treatment ease for the physician, efficient panretinal photocoagulation pattern laser, excellent documentation, and advanced laser training. This article compares navigated laser systems with available conventional and PASCAL laser systems based on the literature and personal experience of the authors.
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Affiliation(s)
- Jay Chhablani
- Vitreo-retina Services, L. V. Prasad Eye Institute, Hyderabad, India
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Bandello F, Lattanzio R, Zucchiatti I, Del Turco C. Pathophysiology and treatment of diabetic retinopathy. Acta Diabetol 2013; 50:1-20. [PMID: 23277338 DOI: 10.1007/s00592-012-0449-3] [Citation(s) in RCA: 112] [Impact Index Per Article: 10.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/16/2012] [Accepted: 12/11/2012] [Indexed: 01/07/2023]
Abstract
In the past years, the management of diabetic retinopathy (DR) relied primarily on a good systemic control of diabetes mellitus, and as soon as the severity of the vascular lesions required further treatment, laser photocoagulation or vitreoretinal surgery was done to the patient. Currently, even if the intensive metabolic control is still mandatory, a variety of different clinical strategies could be offered to the patient. The recent advances in understanding the complex pathophysiology of DR allowed the physician to identify many cell types involved in the pathogenesis of DR and thus to develop new treatment approaches. Vasoactive and proinflammatory molecules, such as vascular endothelial growth factor (VEGF), play a key role in this multifactorial disease. Current properly designed trials, evaluating agents targeting VEGF or other mediators, showed benefits in the management of DR, especially when metabolic control is lacking. Other agents, directing to the processes of vasopermeability and angiogenesis, are under investigations, giving more hope in the future management of this still sight-threatening disease.
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Affiliation(s)
- Francesco Bandello
- Department of Ophthalmology, Scientific Institute San Raffaele, University Vita-Salute, Milan, Italy.
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