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Evaluation of blood flow on optic nerve head after pattern scan and conventional laser panretinal photocoagulation
摘要： To evaluate the changes in the blood ?ow on retina and the optic nerve head (ONH) after conventional laser treatment and to compare it to that after patterned scanning laser (PASCAL) treatment in patients with severe nonproliferative diabetic retinopathy (S-NPDR). In this prospective, cross-sectional study, the blood ?ow on retina and the ONH was assessed by laser speckle ?owgraphy using the mean blur rate (MBR) in 39 eyes with S-NPDR before, 1, 4, 8, 12 weeks after panretinal photocoagulation (PRP). Of 39 eyes, 17eyes with 17 patients treated by conventional laser and 22 eyes with 22 patients treated by PASCAL. The mean age was 55.5 ± 11.5 years in the conventional laser group, 55.6 ± 11.8 years in the PASCAL group. The MBR-vessel, which can be dominantly expressed as retinal blood ?ow, was signi?cantly reduced after PRP treated by conventional laser (P < .001), but did not change after PRP treated by PASCAL. The ratio of MBR-vessel to the baseline was signi?cantly lower in the conventional laser group only at Week 1 (P = .045). The MBR-tissue, which can be dominantly expressed as the ONH blood ?ow, did not signi?cantly change after PRP in the both group. The multiple stepwise regression analysis revealed that the laser burns was an independent factor signi?cantly correlated with the ratio of MBR-vessel at Week 1 to the baseline (b = (cid:1)0.550, P = .012). The retinal blood ?ow was signi?cantly reduced during the 12 weeks only after completion of PRP by conventional laser treatment. Our results indicate that short pulse on PRP treatment performed by the PASCAL would not signi?cantly reduce the retinal blood ?ow.
关键词： laser speckle ?owgraphy,patterned scanning laser,panretinal photocoagulation,mean blur rate,retinal blood ?ow
更新于2025-09-12 10:27:22
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COMPARATIVE EVALUATION OF ANTERIOR SEGMENT OPTICAL COHERENCE TOMOGRAPHY, ULTRASOUND BIOMICROSCOPY, AND INTRAOCULAR PRESSURE CHANGES AFTER PANRETINAL PHOTOCOAGULATION BY PASCAL AND CONVENTIONAL LASER
摘要： Purpose: To compare intraocular pressure, anterior segment optical coherence tomography, and ultrasound biomicroscopy parameters over 3 months after panretinal photocoagulation (PRP) for proliferative diabetic retinopathy after 1 of 2 sittings by conventional laser (half PRP) and a single sitting of Pattern Scan Laser (PASCAL) PRP. Methods: This was a prospective, randomized, interventional study. All tests were performed at baseline, and at 1, 6, and 24 hours, and 1, 4, 8, and 12 weeks after PRP. Results: The intraocular pressure at 1 hour and 6 hours after PRP was significantly raised in both groups. Mean intraocular pressure was 21.17 ± 4.01 mmHg after PASCAL and 17.48 ± 3 mmHg after conventional laser at 1 hour, P , 0.001. On anterior segment optical coherence tomography, conventional laser PRP caused a more significant narrowing of angle-opening distance (AOD750) and trabecular-iris space area (TISA 500), P = 0.03 and 0.04, respectively, on Day 1. Ultrasound biomicroscopy showed a significantly narrow angle in both groups on Day 1. A significant increase in ciliary body thickness was observed in both groups, with 57.1% of PASCAL and 100% of conventionally treated eyes showing ciliary effusion on Day 1 that decreased but persisted for the next 3 months. Conclusion: Performing PRP in sittings, prescribing previous glaucoma medications in patients at risk, and recording intraocular pressure an hour after the PRP could decrease complications.
关键词： panretinal photocoagulation,proliferative diabetic retinopathy,conventional laser and PASCAL
更新于2025-09-12 10:27:22
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Comparison of navigated laser and conventional single-spot laser system for induced pain during panretinal photocoagulation
摘要： To compare the panretinal photocoagulation (PRP)–induced pain response between novel navigated laser (Navilas) and conventional single-spot laser. The eyes were randomly assigned to Navilas or conventional laser. Contralateral eyes underwent PRP with the other system with 30 min resting interval. Pulse duration was 100 ms in conventional laser and 30 ms or 100 ms in Navilas and power setting was enough to create gray-white light burn on both devices. Pain response was evaluated by verbal scale (VS) (0–4) and visual analog scale (VAS) (0–10) after each PRP application. The mean age of 70 patients (140 eyes) was 62.52 ± 9.49 years. Mean power and spot numbers for Navilas and conventional laser were 291.9 ± 85.3 mW vs 368.4 ± 72.0 mW, and 375.4 ± 108.4 vs 374.2 ± 105.0 (p < 0.001 and p = 0.53, respectively). Pain scores for Navilas and conventional laser were 1.19 ± 0.73 and 1.99 ± 0.84 for VS and 2.41 ± 1.65 and 4.74 ± 2.17 for VAS (p < 0.001 and p < 0.001). More comfortable PRP is achieved with Navilas system in comparison with conventional single-spot laser system. However, small number of patients treated with same pulse duration and different contact lenses used for two systems should be taken into consideration. Besides, we did not report comparative clinical efficiency of either laser system.
关键词： Proliferative diabetic retinopathy,PRP,Navilas,Pain,Panretinal photocoagulation
更新于2025-09-11 14:15:04
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Analysis of Choroidal Thickness and Vascular Density Using Optical Coherence Tomography Angiography after Laser Photocoagulation
摘要： Purpose: To evaluate the changes in choroidal thickness and superficial vascular density of the macula and optic disc using optical coherence tomography angiography after laser photocoagulation. Methods: We conducted a retrospective chart review of 25 eyes of diabetic retinopathy patients who underwent panretinal photocoagulation. The macula and optic disc were divided into nine areas, and the vascular density of each area was quantitatively measured using optical coherence tomography angiography. The changes in vascular density and choroidal thickness were analyzed before laser photocoagulation and at 1 week after, 1 month after, and 3 months after treatment. Results: In the panretinal photocoagulation group, the average vascular densities of the macula were 13.5 ± 3.6 mm-1 before treatment, and 14.7 ± 3.1 mm-1 after 1 week, 13.7 ± 2.6 mm-1 after 1 month, and 12.8 ± 3.8 mm-1 after 3 months of treatment. The average vascular densities of the optic disc were 14.7 ± 5.2 mm-1 before treatment, and 14.1 ± 4.7 mm-1 after 1 week, 14.8 ± 5.3 mm-1 after 1 month, and 15.0 ± 4.7 mm-1 after 3 months of treatment. The average subfoveal choroidal thicknesses were 327.5 ± 57.9 μm before treatment, and 334.4 ± 52.5 μm after 1 week, 291.2 ± 52.9 μm after 1 month, and 286.3 ± 44.4 μm after 3 months of treatment. Conclusions: The vascular density of the macula increased temporarily after 1 week of treatment but decreased afterwards. The vascular density of the optic disc decreased after 1 week of laser treatment but increased over time. The subfoveal choroidal thickness increased after 1 week of laser treatment but decreased afterwards.
关键词： Vascular density,Panretinal photocoagulation,Optical coherence tomography angiography
更新于2025-09-11 14:15:04
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Sequence effect in the treatment of proliferative diabetic retinopathy with intravitreal ranibizumab and panretinal photocoagulation
摘要： 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.
关键词： proliferative diabetic retinopathy,panretinal photocoagulation,treatment sequence,Intravitreal ranibizumab
更新于2025-09-04 15:30:14