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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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SEVERE RECURRENT FIBROVASCULAR PROLIFERATION AFTER COMBINED INTRAVITREAL BEVACIZUMAB INJECTION AND LASER PHOTOCOAGULATION FOR AGGRESSIVE POSTERIOR RETINOPATHY OF PREMATURITY
摘要： To describe the clinical features of severe recurrent fibrovascular proliferation after combined intravitreal bevacizumab injections and laser photocoagulation for aggressive posterior retinopathy of prematurity. This retrospective, nonrandomized case series reviewed the medical and ophthalmic records in the referral hospital and our hospital. Four patients (seven eyes) with aggressive posterior retinopathy of prematurity. The patients were referred for vitrectomy with/without lensectomy for recurrent fibrovascular proliferation with a tractional retinal detachment after combined intravitreal bevacizumab injections and laser photocoagulation. Three patients were born at 22 weeks or 23 weeks’ gestational age and one patient at 29 weeks’ gestational age. Preoperatively, fluorescein angiography images showed all eyes had tractional retinal detachment from regrowth of fibrovascular proliferation 3 months to 5 months after the intravitreal bevacizumab injection and abnormal retinal vasculature; four eyes had a broad ischemic retina. Postoperatively, four eyes had retinal attachment and three eyes a total retinal detachment. Neovascular glaucoma developed in five of the seven eyes during the clinical course. Severe fibrovascular proliferation may recur due to widespread retinal ischemia with capillary dropout and abnormal vasculature after failed combined intravitreal bevacizumab and laser photocoagulation therapy as the initial treatment for aggressive posterior retinopathy of prematurity. Careful follow-up is important especially after anti–vascular endothelial growth factor treatment, with recognition that severe reactivation is possible.
关键词： intravitreal bevacizumab injection,vitrectomy,retinopathy of prematurity,fluorescein angiography,stage 5 ROP,vascular endothelial growth factor,stage 4 ROP,fibrovascular proliferation,laser photocoagulation,ROP surgery
更新于2025-09-12 10:27:22
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Rescue with intravitreal bevacizumab in aggressive posterior retinopathy of prematurity poorly responsive to laser treatment
摘要： Successful management of a case of aggressive posterior retinopathy of prematurity (APROP) poorly responsive to laser therapy with intravitreal bevacizumab (IVB) is discussed. IVB is useful as rescue therapy in such cases, if given within the correct window period post laser therapy.
关键词： Aggressive posterior retinopathy of prematurity (APROP),laser in retinopathy of prematurity (ROP),anti-vascular endothelial growth factor (anti-VEGF)
更新于2025-09-11 14:15:04
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Regression Rates Following the Treatment of Aggressive Posterior Retinopathy of Prematurity with Bevacizumab Versus Laser: 8-Year Retrospective Analysis
摘要： Retinopathy is a serious complication related to prematurity and a leading cause of childhood blindness. The aggressive posterior form of retinopathy of prematurity (APROP) has a worse anatomical and functional outcome following laser therapy, as compared with the classic form of the disease. The main outcome measures are the APROP regression rate, structural outcomes, and complications associated with intravitreal bevacizumab (IVB) versus laser photocoagulation in APROP. This is a retrospective case series that includes infants with APROP who received either IVB or laser photocoagulation and had a follow-up of at least 60 weeks (for the laser photocoagulation group) and 80 weeks (for the IVB group). In the first group, laser photocoagulation of the retina was carried out and in the second group, 1 bevacizumab injection was administered intravitreally. The following parameters were analyzed in each group: sex, gestational age, birth weight, postnatal age and postmenstrual age at treatment, APROP regression, sequelae, and complications. Statistical analysis was performed using Microsoft Excel and IBM SPSS (version 23.0). The laser photocoagulation group consisted of 6 premature infants (12 eyes) and the IVB group consisted of 17 premature infants (34 eyes). Within the laser photocoagulation group, the evolution was favorable in 9 eyes (75%) and unfavorable in 3 eyes (25%). Within the IVB group, APROP regressed in 29 eyes (85.29%) and failed to regress in 5 eyes (14.71%). These differences are statistically significant, as proved by the McNemar test (P<0.001). The IVB group had a statistically significant better outcome compared with the laser photocoagulation group, in APROP in our series.
关键词： Retinopathy of Prematurity,Laser Therapy,Intravitreal Injections
更新于2025-09-11 14:15:04
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Ganglion cell layer thickening in well‐controlled patients with type 1 diabetes: an early sign for diabetic retinopathy?
摘要： Purpose: To evaluate early changes in retinal layers using optical coherence tomography (OCT) in patients with long-standing type 1 diabetes (DM1) receiving intensi?ed insulin therapy. Methods: In a cross-sectional case–control study 150 patients with DM1 and 150 age- and sex-matched healthy control participants underwent OCT imaging. Scans of both eyes were analysed for di?erent layers (NFL, GCL (+IPL), INL, outer layer complex (OLC, including OPL, ONL and ELM) and photoreceptors (PR)) in all sub?elds of an ETDRS grid. All analyses were performed semi-automatically using custom software by certi?ed graders of the Vienna Reading Center. ANOVA models were used to compare the mean thickness of the layers between patients and controls. Results: Six hundred eyes with 512 datapoints in 49 b-scans in each OCT were analysed. Mean thickness in patients/controls was 31.35 lm/30.65 lm (NFL, p = 0.0347), 76.7 lm/73.15 lm (GCL, p ≤ 0.0001), 36.29 lm/37.13 lm (INL, p = 0.0116), 114.34 lm/112.02 lm (OLC, p < 0.0001) and 44.71 lm/44.69 lm (PR, p = 0.9401). When evaluating the ETDRS sub?elds separately for clinically meaningful hypotheses, a signi?cant swelling of the GCL in patients could be found uniformly and a central swelling for the OLC, whereas the distribution of NFL and INL thickening suggests that their statistical signi?cance was not clinically relevant. Conclusion: These preliminary results demonstrate that preclinical retinal changes in patients with long-standing DM1 can be found by retinal layer evaluation. However, the changes are layer-speci?c, with signi?cant thickening of the GCL and less so of the OLC suggesting a role as an early sign for di?use swelling and the evolution of DME even in well-controlled diabetes.
关键词： diabetic retinopathy – early detection – early disease – image analysis – OCT
更新于2025-09-11 14:15:04
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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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Comparison of Nd:YAG laser (532 nm green) vs diode laser (810 nm) photocoagulation in the treatment of retinopathy of prematurity: an evaluation in terms of complications
摘要： Purpose To compare the anterior and posterior segment complications of diode (810 nm) laser photocoagulation (LPC) and Nd:YAG (532 nm green) LPC in the treatment of retinopathy of prematurity (ROP). Patients and methods The 84 eyes of 43 patients treated with diode LPC (group 1) and 58 eyes of 31 patients treated with Nd:YAG LPC (group 2) for ROP in our clinic were enrolled in the study. Medical records of all patients were investigated retrospectively. The patients in each group were examined in terms of birth weights, gestational weeks, stage of retinopathy, number of lasers pots, laser parameters, and anterior and posterior complications of LPC. Results The mean birth weeks of group 1 patients were postmenstrual 27.7 ± 2.5 (23–33), while the mean birth weights were 1006.0 ± 334.5 (540–1980) grams. The mean birth weeks of group 2 patients were postmenstrual 27.4 ± 2.6 (23–33), while the mean birth weights were 1073.8 ± 329.2 (480–1720) grams. The mean numbers of laser spots were 1036.0 ± 515.2 (430–2410) in group 1 per eye, while the mean numbers of laser spots were 1085.4 ± 526.0 (445–2530) in group 2 per eye (p ≥ 0.05). Additional laser application was performed in four eyes (4.8%) in group 1 and four eyes (6.9%) in group 2. Four eyes (4.8%) treated with diode LPC and one eye (1.7%) treated with Nd:YAG laser developed retinal detachment. Two eyes of a patient (3.4%) applied Nd:YAG LPC developed cataract. Conclusion Cataract may develop when Nd:YAG laser is used; however, posterior segment complications may be more likely to appear with the use of diode laser in these cases.
关键词： Nd:YAG laser photocoagulation,Cataract,Diode laser photocoagulation,Exudative retinal detachment,Retinopathy of prematurity
更新于2025-09-11 14:15:04
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Retinal and Choroidal Perfusion Status in the Area of Laser Scars Assessed With Swept-Source Optical Coherence Tomography Angiography
摘要： To evaluate the perfusion status of the retina and choriocapillaris in the area of laser scars on swept-source optical coherence tomography angiography (OCTA) images of eyes previously treated with panretinal photocoagulation (PRP).
关键词： diabetic retinopathy,OCT angiography,laser photocoagulation,choriocapillaris
更新于2025-09-11 14:15:04
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Comparison of pain experience and time required for pre-planned navigated peripheral laser versus conventional multispot laser in the treatment of diabetic retinopathy
摘要： Purpose To compare the pain and the duration of a panretinal photocoagulation (PRP) session using a conventional multispot laser (Quantel Medical) versus the Navilas? laser. Methods Treatment-na?ve patients requiring bilateral PRP for diabetic retinopathy were included. For each patient, PRP was carried out using a conventional multispot laser (Quantel Medical, 577?nm) in one eye and the other eye was treated with the Navilas laser (OD-OS, 577?nm). For both PRP treatments, similar parameters (same power, exposure time, number, size and spacing of the spots) were used. For each eye, the duration of the session and the pain, measured using respectively a chronometer and a visual analogic scale (VAS), were recorded. Results Thirty-two eyes of sixteen patients (mean age 57 ± 13 SD, range 28–74), 11 men and 5 women, have been included. A mean of 1289 (1000–1500) spots with a mean power of 352?mW (300–450?mW) and an exposure time of 27?ms (20–30?ms) were delivered. The PRP session with the Navilas laser (mean time of 5.2 ± 0.8?min) was faster than with the conventional multispot laser (6.6 ± 1.1?min) (p = 0.02). Laser-induced pain was significantly reduced (VAS of 2.4 ± 1.6) using the Navilas laser compared to conventional laser (VAS: 7.1 ± 2) (p < 0.001). Conclusion The PRP sessions using the Navilas laser were significantly faster and less painful than with a conventional multispot laser in our series.
关键词： Diabetic retinopathy,Conventional multispot laser,Navilas?,Navigated-PRP
更新于2025-09-11 14:15:04
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QUALITY IMPROVEMENT OF LASER TREATMENT (QUILT)A New Retinal Laser Simulation System for Training in Resource-Poor Countries
摘要： In resource-poor countries, there is a reported lack of quality and structured retinal laser training in residency and hospital eye programs. This unmet training need has been validated in current international diabetic retinopathy screening centers. Quality Improvement of Laser Treatment (QUILT) is a novel laser photocoagulation simulator that contains modules for laser treatment of PDR, diabetic macular edema (DME), retinal vein occlusion, and laser retinopexy. The primary objective of the QUILT simulation is to introduce a new bespoke application to support practical skills training in retinal laser treatment in countries where laser training is suboptimal for ophthalmologists and trainees/residents. The application was first developed as an online application but has subsequently been developed as a standalone application that can be downloaded or copied onto individual laptops or computers, so that the training is not dependent on a good internet connection.
关键词： diabetes,simulator,proliferative diabetic retinopathy,laser training,simulation,pattern scan laser,retinopexy,macular edema
更新于2025-09-11 14:15:04