Preliminary clinical observation of short-pulse pattern scan laser photocoagulation treatment in diabetic retinopathy_Chinese Journal of Ocular Fundus Diseases

Authors：

WuPeipei , YeHaiyun , ZhongXiaojing , 田臻 , 欧杰雄 , 于珊珊 , 林婉意 ,  金陈进

Zhongshan Ophthalmic Center, Sun Yat-Sen University, Guangzhou 510060, China;

Corresponding author：

金陈进, Email: jinchj@mail.sysu.edu.cn

Keywords：

Diabetic retinopathy/therapy; Laser coagulation

DOI：

10.3760/cma.j.issn.1005-1015.2014.02.009

Video：

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Objective To investigate the clinical outcome and therapeutic efficacy of short-pulse pattern scan laser (PASCAL) photocoagulation for diabetic retinopathy (DR). Methods Forty-three DR patients (70 eyes) including 19 males (32 eyes) and 24 females (38 eyes) underwent short-pulse PASCAL pan-retinal photocoagulation (PRP). There were 24 patients (42 eyes) with proliferative diabetic retinopathy (PDR) and 19 patients (28 eyes) with severe non-proliferative diabetic retinopathy (NPDR). The best corrected visual acuity was better than or equal to 0.1 in 62 eyes, worse than 0.1 in 8 eyes. Diabetic macular edema was found in 18 eyes. Short-pulse PASCAL PRP was applied with multi-spot arrays. Macular edema was treated by PASCAL macular mode (MAC A + MAC B) and/or single spot. Visual acuity and fundus examinations were analyzed at the one-year follow-up procedure. Results One year after short-pulse PASCAL treatment, the final visual acuity was improved in 10 eyes, stable in 53 eyes, decreased in 7 eyes; macular edema was relieved in 38 eyes, aggravated in 12 eyes, and stable in 20 eyes. Of 42 eyes with PDR, neovascularization were regressed in 20 eyes, uncontrolled in 11 eyes which experienced additional photocoagulation (1-2 times) during the follow-up. Among the 11 uncontrolled eyes, 3 eyes (3/11) received vitrectomy due to vitreous hemorrhage. Conclusion PASCAL might stabilize the progress of diabetic retinopathy safely and effectively.

Citation： WuPeipei, YeHaiyun, ZhongXiaojing. Preliminary clinical observation of short-pulse pattern scan laser photocoagulation treatment in diabetic retinopathy. Chinese Journal of Ocular Fundus Diseases, 2014, 30(2): 152-155. doi: 10.3760/cma.j.issn.1005-1015.2014.02.009 Copy

1.	The Diabetic Retinopathy Study Research Group. Photocoagul-ation treatment of proliferative diabetic retinopathy:clinical application of Diabetic Retinopathy Study(DRS) findings, DRS report number 8[J]. Ophthalmology, 1981, 88:583-600.
2.	Early Treatment Diabetic Retinopathy Study Research Group. Early photocoagulation for diabetic retinopathy:ETDRS report number 9[J]. Ophthalmology, 1991, 98(5 Suppl):766-785.
3.	Al-Hussainy S, Dodson PM, Gibson JM.Pain response and follow-up of patients undergoing panretinal laser photocoagulation with reduced exposuretimes[J].Eye (Lond), 2008, 22:96-99.
4.	Wilkinson CP, Ferris FL 3rd, Klein RE, et al. Proposed international clinical diabetic retinopathy and diabetic macular edema disease severity scales[J]. Ophthalmology, 2003, 110:1677-1682.
5.	Diabetic Retinopathy Study Research Group. Indications for photocoagulation treatment of diabetic retinopathy:DRS report no.14[J]. Int Ophthalmol Clin, 1987, 27:239-253.
6.	Diabetic Retinopathy Study Research Group. Photocoagulation treatment of proliferative diabetic retinopathy:the second report of the Diabetic Retinopathy Study findings[J]. Ophthalmology, 1978, 85:82-106.
7.	Kaiser RS, Maguire MG, Grunwald JE, et al.One-year outcomes of panretinal photocoagulation in proliferative diabetic retinopathy[J].Am J Ophthalmol, 2000, 129:1778-1785.
8.	Klein R, Klein BE, Moss SE, et al.The Wisconsin epidemiologic study of diabetic retinopathy. Ⅱ:prevalence and risk of diabetic retinopathy whenage at diagnosis is less than 30 years[J].Arch Ophthalmol, 1984, 102:520-526.
9.	Jain A, Blumenkranz MS, Paulus Y, et al.Effect of pulse duration on size and character of the lesion in retinal photocoagulation[J].Arch Ophthalmol, 2008, 126:78-85.
10.	Muqit MM, Gray JC, Marcellino GR, et al.Fundus autofluorescence and Fourier-domain optical coherence tomography imaging of 10 and 20 millisecond Pascal retinal photocoagulation treatment[J].Br J Ophthalmol, 2009, 93:518-525.
11.	Blumenkranz MS, Yellachich D, Andersen DE, et al.Semiautomated patterned scanning laser for retinal photocoagulation[J].Retina, 2006, 26:370-376.
12.	Sanghvi C, McLauchlan R, Delgado C, et al.Initial experience with the Pascal photocoagulator:a pilot study of 75 procedures[J]. Br J Ophthalmol, 2008, 92:1061-1064.
13.	Nagpal M, Marlecha S, Nagpal K.Comparison of laser photocoagulation for diabetic retinopathy using 532-nm standard laser versus multispotpattern scan laser[J].Retina, 2010, 30:452-458.
14.	Muqit MM, Marcellino GR, Henson DB, et al.Single-session vs multiple-session pattern scanning laser panretinal photocoagulation in proliferative diabeticretinopathy:the Manchester pascal study[J].Arch Ophthalmol, 2010, 128:525-533.
15.	Muqit MM, Marcellino GR, Henson DB, et al.Randomized clinical trial to evaluate the effects of Pascal panretinal photocoagulation on macular nerve fiberlayer:Manchester Pascal Study report 3[J].Retina, 2011, 31:1699-1707.
16.	Muraly P, Limbad P, Srinivasan K, et al.Single session of Pascal versus multiple sessions of conventional laser for panretinal photocoagulation inproliferative diabetic retinopathy:a comparitive study[J].Retina, 2011, 31:1359-1365.
17.	Muqit MM, Sanghvi C, McLauchlan R, et al.Study of clinical applications and safety for Pascal? laser photocoagulation in retinal vascular disorders.Acta Ophthalmol, 2012, 90:155-161.

1. The Diabetic Retinopathy Study Research Group. Photocoagul-ation treatment of proliferative diabetic retinopathy:clinical application of Diabetic Retinopathy Study(DRS) findings, DRS report number 8[J]. Ophthalmology, 1981, 88:583-600.
2. Early Treatment Diabetic Retinopathy Study Research Group. Early photocoagulation for diabetic retinopathy:ETDRS report number 9[J]. Ophthalmology, 1991, 98(5 Suppl):766-785.
3. Al-Hussainy S, Dodson PM, Gibson JM.Pain response and follow-up of patients undergoing panretinal laser photocoagulation with reduced exposuretimes[J].Eye (Lond), 2008, 22:96-99.
4. Wilkinson CP, Ferris FL 3rd, Klein RE, et al. Proposed international clinical diabetic retinopathy and diabetic macular edema disease severity scales[J]. Ophthalmology, 2003, 110:1677-1682.
5. Diabetic Retinopathy Study Research Group. Indications for photocoagulation treatment of diabetic retinopathy:DRS report no.14[J]. Int Ophthalmol Clin, 1987, 27:239-253.
6. Diabetic Retinopathy Study Research Group. Photocoagulation treatment of proliferative diabetic retinopathy:the second report of the Diabetic Retinopathy Study findings[J]. Ophthalmology, 1978, 85:82-106.
7. Kaiser RS, Maguire MG, Grunwald JE, et al.One-year outcomes of panretinal photocoagulation in proliferative diabetic retinopathy[J].Am J Ophthalmol, 2000, 129:1778-1785.
8. Klein R, Klein BE, Moss SE, et al.The Wisconsin epidemiologic study of diabetic retinopathy. Ⅱ:prevalence and risk of diabetic retinopathy whenage at diagnosis is less than 30 years[J].Arch Ophthalmol, 1984, 102:520-526.
9. Jain A, Blumenkranz MS, Paulus Y, et al.Effect of pulse duration on size and character of the lesion in retinal photocoagulation[J].Arch Ophthalmol, 2008, 126:78-85.
10. Muqit MM, Gray JC, Marcellino GR, et al.Fundus autofluorescence and Fourier-domain optical coherence tomography imaging of 10 and 20 millisecond Pascal retinal photocoagulation treatment[J].Br J Ophthalmol, 2009, 93:518-525.
11. Blumenkranz MS, Yellachich D, Andersen DE, et al.Semiautomated patterned scanning laser for retinal photocoagulation[J].Retina, 2006, 26:370-376.
12. Sanghvi C, McLauchlan R, Delgado C, et al.Initial experience with the Pascal photocoagulator:a pilot study of 75 procedures[J]. Br J Ophthalmol, 2008, 92:1061-1064.
13. Nagpal M, Marlecha S, Nagpal K.Comparison of laser photocoagulation for diabetic retinopathy using 532-nm standard laser versus multispotpattern scan laser[J].Retina, 2010, 30:452-458.
14. Muqit MM, Marcellino GR, Henson DB, et al.Single-session vs multiple-session pattern scanning laser panretinal photocoagulation in proliferative diabeticretinopathy:the Manchester pascal study[J].Arch Ophthalmol, 2010, 128:525-533.
15. Muqit MM, Marcellino GR, Henson DB, et al.Randomized clinical trial to evaluate the effects of Pascal panretinal photocoagulation on macular nerve fiberlayer:Manchester Pascal Study report 3[J].Retina, 2011, 31:1699-1707.
16. Muraly P, Limbad P, Srinivasan K, et al.Single session of Pascal versus multiple sessions of conventional laser for panretinal photocoagulation inproliferative diabetic retinopathy:a comparitive study[J].Retina, 2011, 31:1359-1365.
17. Muqit MM, Sanghvi C, McLauchlan R, et al.Study of clinical applications and safety for Pascal? laser photocoagulation in retinal vascular disorders.Acta Ophthalmol, 2012, 90:155-161.

Chinese Journal of Ocular Fundus Diseases

Preliminary clinical observation of short-pulse pattern scan laser photocoagulation treatment in diabetic retinopathy

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