Effect of wavelength in the efficacy for treatment of non-proliferative diabetic retinopathy_Chinese Journal of Ocular Fundus Diseases

Authors：

ZhangMoli , TianBei ,  WeiWenbin

Beijing Ophthalmology & Visual Science Key Laboratory Beijing Tongren Eye Center,Beijing Tongren Hospital, Captial Medical University,Beijing 100730, China;

Corresponding author：

WeiWenbin, Email: wenbing_wei@aliyun.com

Keywords：

Diabetic retinopathy/therapy; Laser coagulation

DOI：

10.3760/cma.j.issn.1005-1015.2016.02.006

Video：

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Objective To compare the therapeutic effects of 577 nm laser and 532 nm laser panretinal photocoagulation (PRP) in the treatment of non-proliferative diabetic retinopathy (NPDR). Methods This is a prospective controlled study. A total of 23 patients (41 eyes) with clinically diagnosed severe NPDR were randomly divided into two groups including 577 nm group (11 patients, 20 eyes) and the 532 nm group (12 patients, 21 eyes). 577 nm group and 532 nm group received 3 - 4 times PRP with single-point mode. The laser energy and the number of laser spots were compared, and the laser energy density was calculated. Before treatment and 1 day, 1, 3, 6 and 12 months after treatment, the changes of best corrected visual acuity (BCVA), average threshold sensitivity, a/b-wave amplitude of flash ERG (F-ERG) in the 30° - 60° visual field, and fundus fluorescein angiography (FFA) were compared between two groups. Results The response rate was 85.0% and 23.8%, respectively in the 577 nm and 532 nm group, the difference was statistically significant (χ²=15.43，P < 0.05).Compare to the pre-treatment measurement, the average threshold sensitivity, a/b wave amplitude of F-ERG and the 30° - 60°visual field were reduced at 1 day after treatment both in the 577 nm and 532 nm group, the difference were statistically significant (F=8.68, 7.57, 4.52; P < 0.05). The average threshold sensitivity (t=2.41, 3.48, 1.23), a/b wave amplitude (a wave: t=5.82, 4.45, 7.83；b wave: t=5.40, 3.23, 4.67) of F-ERG were different between 577 nm and 532 nm group at 3 , 6 and 12 months after treatment (P < 0.05). There was no retinal neovascularization and non-perfusion region in two groups at 6 months after treatment. The average laser power were (436.25±54.65) and (446.43±35.61) mW, number of laser spots were (1952.95±299.09) and (2119.05±302.69) spots, energy density were (7.60±1.30) and (7.60±3.00) mW×ms/μm² in the 577 nm group and 532 nm group, respectively. There was no difference in average laser power (t=1.35), number of laser spots (t=2.85) and energy density (t=1.99) between two groups (P > 0.05). Conclusion Compared with the 532 nm laser, 577 nm laser treatment has better visual outcomes for NPDR patients.

Citation： ZhangMoli, TianBei, WeiWenbin. Effect of wavelength in the efficacy for treatment of non-proliferative diabetic retinopathy. Chinese Journal of Ocular Fundus Diseases, 2016, 32(2): 135-139. doi: 10.3760/cma.j.issn.1005-1015.2016.02.006 Copy

1.	Fong DS,Ferris FL 3rd,Davis MD,et al.Early Treatment Diabetic Retinopathy Study Research Group.Causes of severe visual loss in the early treatment diabetic retinopathy study: ETDRS report no.24[J].Am J Ophthalmol,1999,127(2):137-141.
2.	Alghadyan AA.Diabetic retinopathy-an update[J].Saudi J Ophthalmol, 2011,25(2): 99-111.DOI:10.1016/j.sjopt.2011.01.009.
3.	Shah AM, Bressler NM, Jampol LM. Does laser still have a role in the management of retinal vascular and neovascular diseases?[J] Am J Ophthalmol, 2011, 152 (3): 332-339. DOI:10.1016/j.ajo.2011.04.015.
4.	Sramek CK, Leung LS, Paulus YM,et al.Therapeutic window of retinal photocoagulation with green (532-nm) and yellow (577-nm) lasers[J].Ophthalmic Surg Lasers Imaging,2012,43(4):341-347. DOI:10.3928/15428877-20120426-05.
5.	Kwon YH,Lee DK,Kwon OW.The short-term efficacy of subthreshold Micropulse yellow (577-nm) laser photocoagulation for diabetic macular edema[J].Korean J Ophthalmol,2014,28(5):379-385.DOI:10.3341/kjo.2014.28.5.379.
6.	Early Treatment Diabetic Retinopathy Study Research Group. Fundus photographic risk factor for progression of diabetic retinopathy: ETDRS report number 12[J]. Ophthalmology,1991,98(5 Suppl):S823-833.
7.	Wilkinson CP, Ferris FL, Klein RE, et al.Proposed international clinical diabetic retinopathy and diabetic macular edema disease severity scales[J].Ophthalmology, 2003,110(9):1676-1682.
8.	田蓓,朱晓青,胡庆军,等.全视网膜激光光凝顺序差异对重度非增殖期糖尿病视网膜病变的效果影响[J].眼科, 2011, 20(4):240-243.Tian B, Zhu XQ, Hu QJ,et al.The effect of different sequence of panretinal photocoagulation on severe non-proliferation diabetic retinopathy[J].Ophthalmol CHN,2011, 20(4):240-243.
9.	Perente I,Alkin Z,Ozkaya A,et al.Focal laser photocoagulation in non-center involved diabetic macular edema[J].Med Hypothesis Discov Innov Ophthalmol,2014,3 (1): 9-16.
10.	范围,邹欢,袁容娣.糖尿病黄斑水肿治疗研究现状与进展[J].中华眼底病杂志,2015,31(2):198-201.DOI:10.3760/cma.j.issn.1005-1015.2015.02.027.Fan W,Zou H,Yuan RD.Diabetic macular edema therapy research status and progress[J].Chin J Ocul Fundus Dis, 2015, 31(2): 198-201. DOI:10.3760/cma.J.issn.1005-1015.2015.02.027.
11.	Tso MOM.Retinal photocoagulation therapy: clinical application and biological basis of therapeutic effects[M]// Tso MOM .Retinal disease. Philadelphia, Philadelphia JB Lippincott Company,1988:247-250.
12.	The Early Treatment Diabetic Retinopathy Study Research Group.Techniques for scatter and local photocoagulation treatment of diabetic retinopathy: Early Treatment Diabetic Retinopathy Study Report no.3[J].Int Ophthalmol Clin,1987, 27(4):254-264.
13.	吴培培,叶海昀,钟晓菁,等.短脉冲模式扫描激光治疗糖尿病视网膜病变疗效观察[J].中华眼底病杂志,2014,30(2):152-155.DOI:10.3760/cma.j.issn.1005-1015.2014.02.009.Wu PP,Ye HY,Zhong XJ,et al.Preliminary clinical observation of short-pulse pattern retinopathy[J].Chin J Ocul Fundus Dis,2014,30(2):152-155.DOI:10.3760/cma.j.issn.1005-1015.2014.02.009.
14.	李俊,吴伯乐,叶锌铭, 等. 曲安奈德联合577 nm激光治疗黄斑囊样水肿临床研究[J].国际眼科杂志,2014, 14(12):2155-2157.Li J,Wu BL,Ye XM,et al.Clinical observation of retrobulbar injection of triamcinolone acetonide combined 577nm laser macular grid photocoagulation for the treatment of cystoid macular edema[J].Int Eye Sci,2014, 14(12):2155-2157.
15.	侯军军,闫爱珍,袁红,等.577 nm阈下微脉冲激光与传统激光治疗糖尿病黄斑水肿的近期疗效比较[J]. 中国实用眼科杂志,2012,30(6):657-659.DOI:10.3760/cma.j.issn.1006-4443.2012.06.006.Hou JJ,Yan AZ,Yuan H,et al.Comparison of the efficacy between subthreshold micropulse 577nm laser and traditional laser for diabetic macular edema[J].Chin J Exp Ophthalmol,2012,30(6):657-659.DOI:10.3760/cma.j.issn.1006-4443.2012.06.006.
16.	Kwon YH, Lee DK, Kwon OW.The short-term efficacy of subthreshold Micropulse yellow (577-nm) laser photocoagulation for diabetic macular edema[J].Korean J Ophthalmol,2014,28(5):379-385.DOI:10.3341/kjo.2014.28.5.379.
17.	Inagaki K, Ohkoshi K, Ohde S, et al. Comparative efficacy of pure yellow (577-nm) and 810-nm subthreshold micropulse laser photocoagulation combined with yellow (561-577-nm) direct photocoagulation for diabetic macular edema[J]. Jpn J Ophthalmol, 2015,59(1):21-28.DOI:10.1007/s10384-014-0361-1.

1. Fong DS,Ferris FL 3rd,Davis MD,et al.Early Treatment Diabetic Retinopathy Study Research Group.Causes of severe visual loss in the early treatment diabetic retinopathy study: ETDRS report no.24[J].Am J Ophthalmol,1999,127(2):137-141.
2. Alghadyan AA.Diabetic retinopathy-an update[J].Saudi J Ophthalmol, 2011,25(2): 99-111.DOI:10.1016/j.sjopt.2011.01.009.
3. Shah AM, Bressler NM, Jampol LM. Does laser still have a role in the management of retinal vascular and neovascular diseases?[J] Am J Ophthalmol, 2011, 152 (3): 332-339. DOI:10.1016/j.ajo.2011.04.015.
4. Sramek CK, Leung LS, Paulus YM,et al.Therapeutic window of retinal photocoagulation with green (532-nm) and yellow (577-nm) lasers[J].Ophthalmic Surg Lasers Imaging,2012,43(4):341-347. DOI:10.3928/15428877-20120426-05.
5. Kwon YH,Lee DK,Kwon OW.The short-term efficacy of subthreshold Micropulse yellow (577-nm) laser photocoagulation for diabetic macular edema[J].Korean J Ophthalmol,2014,28(5):379-385.DOI:10.3341/kjo.2014.28.5.379.
6. Early Treatment Diabetic Retinopathy Study Research Group. Fundus photographic risk factor for progression of diabetic retinopathy: ETDRS report number 12[J]. Ophthalmology,1991,98(5 Suppl):S823-833.
7. Wilkinson CP, Ferris FL, Klein RE, et al.Proposed international clinical diabetic retinopathy and diabetic macular edema disease severity scales[J].Ophthalmology, 2003,110(9):1676-1682.
8. 田蓓,朱晓青,胡庆军,等.全视网膜激光光凝顺序差异对重度非增殖期糖尿病视网膜病变的效果影响[J].眼科, 2011, 20(4):240-243.Tian B, Zhu XQ, Hu QJ,et al.The effect of different sequence of panretinal photocoagulation on severe non-proliferation diabetic retinopathy[J].Ophthalmol CHN,2011, 20(4):240-243.
9. Perente I,Alkin Z,Ozkaya A,et al.Focal laser photocoagulation in non-center involved diabetic macular edema[J].Med Hypothesis Discov Innov Ophthalmol,2014,3 (1): 9-16.
10. 范围,邹欢,袁容娣.糖尿病黄斑水肿治疗研究现状与进展[J].中华眼底病杂志,2015,31(2):198-201.DOI:10.3760/cma.j.issn.1005-1015.2015.02.027.Fan W,Zou H,Yuan RD.Diabetic macular edema therapy research status and progress[J].Chin J Ocul Fundus Dis, 2015, 31(2): 198-201. DOI:10.3760/cma.J.issn.1005-1015.2015.02.027.
11. Tso MOM.Retinal photocoagulation therapy: clinical application and biological basis of therapeutic effects[M]// Tso MOM .Retinal disease. Philadelphia, Philadelphia JB Lippincott Company,1988:247-250.
12. The Early Treatment Diabetic Retinopathy Study Research Group.Techniques for scatter and local photocoagulation treatment of diabetic retinopathy: Early Treatment Diabetic Retinopathy Study Report no.3[J].Int Ophthalmol Clin,1987, 27(4):254-264.
13. 吴培培,叶海昀,钟晓菁,等.短脉冲模式扫描激光治疗糖尿病视网膜病变疗效观察[J].中华眼底病杂志,2014,30(2):152-155.DOI:10.3760/cma.j.issn.1005-1015.2014.02.009.Wu PP,Ye HY,Zhong XJ,et al.Preliminary clinical observation of short-pulse pattern retinopathy[J].Chin J Ocul Fundus Dis,2014,30(2):152-155.DOI:10.3760/cma.j.issn.1005-1015.2014.02.009.
14. 李俊,吴伯乐,叶锌铭, 等. 曲安奈德联合577 nm激光治疗黄斑囊样水肿临床研究[J].国际眼科杂志,2014, 14(12):2155-2157.Li J,Wu BL,Ye XM,et al.Clinical observation of retrobulbar injection of triamcinolone acetonide combined 577nm laser macular grid photocoagulation for the treatment of cystoid macular edema[J].Int Eye Sci,2014, 14(12):2155-2157.
15. 侯军军,闫爱珍,袁红,等.577 nm阈下微脉冲激光与传统激光治疗糖尿病黄斑水肿的近期疗效比较[J]. 中国实用眼科杂志,2012,30(6):657-659.DOI:10.3760/cma.j.issn.1006-4443.2012.06.006.Hou JJ,Yan AZ,Yuan H,et al.Comparison of the efficacy between subthreshold micropulse 577nm laser and traditional laser for diabetic macular edema[J].Chin J Exp Ophthalmol,2012,30(6):657-659.DOI:10.3760/cma.j.issn.1006-4443.2012.06.006.
16. Kwon YH, Lee DK, Kwon OW.The short-term efficacy of subthreshold Micropulse yellow (577-nm) laser photocoagulation for diabetic macular edema[J].Korean J Ophthalmol,2014,28(5):379-385.DOI:10.3341/kjo.2014.28.5.379.
17. Inagaki K, Ohkoshi K, Ohde S, et al. Comparative efficacy of pure yellow (577-nm) and 810-nm subthreshold micropulse laser photocoagulation combined with yellow (561-577-nm) direct photocoagulation for diabetic macular edema[J]. Jpn J Ophthalmol, 2015,59(1):21-28.DOI:10.1007/s10384-014-0361-1.

Chinese Journal of Ocular Fundus Diseases

Effect of wavelength in the efficacy for treatment of non-proliferative diabetic retinopathy

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