CHANGES IN MACULAR THICKNESS AND VISION IN PATIENTS UNDERGOING PANRETINAL PHOTOCOAGULATION FOR DIABETIC RETINOPATHY WITHOUT MACULAR OEDEMA

Objective:To compare the change in central subfield macular thickness following single-session and multiple-session laser panretinal photocoagulation in subjects with diabetic retinopathy.Methods:A single-center, randomized controlled trial study was performed on 28 eyes of 16 patients with severe non-proliferative diabetic retinopathy or proliferative diabetic retinopathy. Eyes were randomly assigned for treatment with panretinal photocoagulation performed either in single-session or multiple-session divided into three sessions during two-week period. Central subfield macular thickness was quantified using spectral domain optical coherence tomography and changes at four weeks follow-up were compared to the baseline measurement.Result:Mean baseline central subfield macular thickness of 12 eyes underwent single-session and 16 eyes underwent multiple-session panretinal photocoagulation were 342.91+109.51 micrometers and 354+171.79 micrometers (p> .05), respectively. Mean post laser central subfield macular thickness in the single-session group was 305.83+81.95 micrometers and 389.75+229.51 micrometers in the multiple-session group (p> .05). Mean central subfield macular thickness changes four weeks post laser was 37.08+94.21 micrometers for eyes treated with single-session and -35.75+123.62 micrometers for the multiple-session treated eyes (p= .101).Conclusion:There was no significant difference in change of central subfield macular thickness at four weeks post laser from treatment with single-session and multiple-session panretinal photocoagulation. Single-session panretinal photocoagulation can be used as effective multiple-session panretinal photocoagulation for the treatment of diabetic retinopathy.

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Changes in Central Macular Thickness following Single Session Multispot Panretinal Photocoagulation

Journal of Ophthalmology ◽

10.1155/2015/529529 ◽

2015 ◽

Vol 2015 ◽

pp. 1-6 ◽

Cited By ~ 3

Author(s):

Nawat Watanachai ◽

Janejit Choovuthayakorn ◽

Direk Patikulsila ◽

Nimitr Ittipunkul

Keyword(s):

Diabetic Retinopathy ◽

Macular Edema ◽

Proliferative Diabetic Retinopathy ◽

Macular Thickness ◽

Panretinal Photocoagulation ◽

Central Macular Thickness ◽

Newly Diagnosed ◽

Single Session ◽

Corrected Visual Acuity

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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Sequence effect in the treatment of proliferative diabetic retinopathy with intravitreal ranibizumab and panretinal photocoagulation

European Journal of Ophthalmology ◽

10.1177/1120672118812270 ◽

2018 ◽

Vol 30 (1) ◽

pp. 34-39

Author(s):

Guofan Cao ◽

Xiangzhong Xu ◽

Chenghu Wang ◽

Shu Zhang

Keyword(s):

Diabetic Retinopathy ◽

High Risk ◽

Proliferative Diabetic Retinopathy ◽

Additional Treatment ◽

Macular Thickness ◽

Panretinal Photocoagulation ◽

Central Macular Thickness ◽

Fundus Fluorescein Angiography ◽

Intravitreal Ranibizumab ◽

The Status

Purpose: To compare the outcome of the sequence in the two treatments (intravitreal ranibizumab and panretinal photocoagulation) in high-risk proliferative diabetic retinopathy. Methods: This retrospective study included 35 patients with newly diagnosed high-risk proliferative diabetic retinopathy in 43 eyes; 18 (22 eyes) received intravitreal ranibizumab before panretinal photocoagulation (intravitreal ranibizumab+ group), while the other 17 (21 eyes) received panretinal photocoagulation before intravitreal ranibizumab (panretinal photocoagulation+ group). Each subject received three intravitreal ranibizumabs that were interleaved with three panretinal photocoagulations. The first treatment (either intravitreal ranibizumab or panretinal photocoagulation) was done 1 week before the second one. The interval between intravitreal ranibizumabs was 4 weeks, panretinal photocoagulation was 2 weeks. The power and pulse duration were determined based upon the status of each retinal spot before each panretinal photocoagulation. The retinal non-perfusion region was measured with fundus fluorescein angiography before and 1 month after the final treatment. The central macular thickness was measured with optical coherence tomography within 1 week before the first treatment, before each panretinal photocoagulation, and 1 month after the final intravitreal ranibizumab. Results: The panretinal photocoagulation energy required for effective treatment was lower in intravitreal ranibizumab+ group in the first and second sessions and in total energy (p < 0.05). Central macular thickness reduction before the second panretinal photocoagulation session was significant in the intravitreal ranibizumab+ group (p < 0.05). Conclusion: The sequence used in intravitreal ranibizumab+ group showed clear advantages over that in panretinal photocoagulation+ group in the treatment of proliferative diabetic retinopathy, not only in the use of lower energy for panretinal photocoagulation but also in the more rapid regression of neovascularization and less need of additional treatment.

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Quantifying alterations of macular thickness before and after panretinal photocoagulation in patients with severe diabetic retinopathy and good vision

Ophthalmology ◽

10.1016/j.ophtha.2003.05.008 ◽

2003 ◽

Vol 110 (12) ◽

pp. 2386-2394 ◽

Cited By ~ 76

Author(s):

Masahiko Shimura ◽

Kanako Yasuda ◽

Toru Nakazawa ◽

Tetsuya Kano ◽

Satsuki Ohta ◽

...

Keyword(s):

Diabetic Retinopathy ◽

Macular Thickness ◽

Panretinal Photocoagulation ◽

Before And After ◽

Good Vision

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Effect of pattern scanning laser on macular thickness in diabetic retinopathy

Therapeutic Advances in Ophthalmology ◽

10.1177/25158414211035860 ◽

2021 ◽

Vol 13 ◽

pp. 251584142110358

Author(s):

Nadine Hamed ◽

Logan Vander Woude ◽

Ramak Roohipourmoallai ◽

Collin Ohning ◽

Kathleen A. Regan ◽

...

Keyword(s):

Diabetic Retinopathy ◽

Treatment Group ◽

Macular Edema ◽

Macular Thickness ◽

Scanning Laser ◽

Treatment Modalities ◽

Panretinal Photocoagulation ◽

Anti Vegf ◽

Spot Number ◽

Time Point

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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