Comparison of the efficacy of multi-point or single-point mode of 577 nm laser in the treatment of diabetic retinopathy_Chinese Journal of Ocular Fundus Diseases

Authors：

ZhangMoli , TianBei ,  WeiWenbin

Beijing Tongren Hospital, Beijing 100730, China;

Corresponding author：

WeiWenbin, Email: tr_weiwenbin@163.com

Keywords：

Diabetic Retinopathy/therapy; Laser coagulation/methods; Laser coagulation/utilization

DOI：

10.3760/cma.j.issn.1005-1015.2015.01.010

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Objective To compare the therapeutic effects of 577 nm laser panretinal photocoagulation (PRP) between one time multi-point scanning mode and multiple time single-point mode in the treatment of eyes with non-proliferative diabetic retinopathy (NPDR). Methods This is a prospective controlled study from August 2013 to February 2014. A total of 29 patients (46 eyes) with clinically diagnosed severe NPDR were randomly divided into two groups including the treatment group (12 patients, 22 eyes) and the control group (17 patients, 224 eyes). The treatment group received one time PRP of multi-point scanning mode, and the control group received 3-4 times of PRP with single-point mode. In order to evaluate its efficacy, the best corrected visual acuity was measured before treatment, and 1 day, 1, 2, 6 and 12 months after treatment. The average threshold sensitivity, a/b-wave amplitude of flash ERG (F-ERG) in the 30°-60° visual field, and fundus fluorescein angiography (FFA) of the change were also compared between the 2 groups. The laser energy and the number of laser spots were compared, and the laser energy density was calculated. Results The response rate was 86.4% and 79.2%, respectively in the treatment and control group, the difference was not statistically significant (χ²=0.414, P > 0.05). Compare to the pre-treatment measurement, the average threshold sensitivity, a/b-wave amplitude of F-ERG in the 30°-60° visual field were reduced at 1 day after treatment both in treatment and control group, the differences were statistically significant (P < 0.05). The average threshold sensitivity, a/b-wave amplitude of F-ERG were no difference between treatment and control group at 2m, 6m and 12m after treatment (P > 0.05). The average laser power, number of laser spots and energy density were (537.50±64.69) mW and (339.09±132.09) mW, (1934.32±426.38) points and (2061.42±375.49) points, (0.35±0.12) mW o ms/μm² and (1.95±0.86) mW·ms/μm² in the treatment group and the control group, respectively. The average laser power and energy density was statistically different between the 2 groups (P < 0.05), while the number of laser spots was no difference (P > 0.05). Conclusions 577 nm multi-point scanning laser can complete the PRP at one time, and achieve the same therapeutic outcomes with the single-point mode which need several times to complete the PRP in the eyes with severe NPDR, and have lower energy density, and thus relative minor function damage.

Citation： ZhangMoli, TianBei, WeiWenbin. Comparison of the efficacy of multi-point or single-point mode of 577 nm laser in the treatment of diabetic retinopathy. Chinese Journal of Ocular Fundus Diseases, 2015, 31(1): 36-40. doi: 10.3760/cma.j.issn.1005-1015.2015.01.010 Copy

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5.	田蓓, 魏文斌, 朱晓青, 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.
6.	Tso MOM. Retinal photocoagulation therapy:clinical application and biological basis of therapeutic effects[M]//Tso MOM.Retinal disease.Philadelphia:J.B. Lippincott Company, 1988:247-250.
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8.	惠玲, 师晓丽, 王雨生, 等.倍频532 nm激光治疗糖尿病视网膜病变50例[J].国际眼科杂志, 2003, 3(4):46-48.
9.	Nagpal M, Marlecha S, Nagpal K, et al. Comparison of laser photocoagulation for diabetic retinopathy using 532 nm standard laser versus multispot pattern scan laser[J]. Retina, 2010, 30(3):452-458.
10.	Muqit MM, Gray JC, Marcellino GR. In vivo laser-tissue interactions and healing responses from 20-vs 100-millisecond pulse Pascal photocoagulation burns[J]. Arch Ophthalmol, 2010, 128(4):448-455.
11.	Muqit MM, Denniss J, Nourrit V, et al. Spatial and spectral imaging of retinal laser photocoagulation burns[J]. Invest Ophthalmol Vis Sci, 2011, 52(2):994-1002.
12.	彭志华, 程谷萌, 吴岚. PASCAL模式扫描光凝治疗糖尿病视网膜病变的疗效观察[J].国际眼科杂志, 2013, 13(8):1639-1641.
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.
14.	Mahiul MK, Muqit MM, Sanghvi C, et al. Study of clinical applications and safety for Pascal^® laser photocoagulation in retinal vascular disorders[J]. Acta Ophthalmol, 2012, 90(2):155-161.
15.	Velez-Montoya R, Guerrero-Naranjo JL, Gonzalez-Mijares CC, et al. Pattern scan laser photocoagulation:safety and complications, experience after 1301 consecutive cases[J]. Br J Ophthalmol, 2010, 94(6):720-724.
16.	Muqit MM, Marcellino GR, Henson DB, et al. Single-session vs. multiplesession pattern scanning laser panretinal photocoagulation in proliferative diabetic retinopathy:the Manchester Pascal Study[J]. Arch Ophthalmol, 2010, 128(5):525-533.
17.	田蓓.糖尿病视网膜病变全视网膜光凝治疗的几个问题[J].眼科, 2014, 23(4):222-225.

1. Maia OO Jr, Takahashi BS, Costa RA, et al. Combined laser and intravitreal triam cinolone for proliferative diabetic retinopathy and macular edema:one-year results of a randomized clinical trial[J].Am J Ophthamlol, 2009, 147(2):291-297.
2. 张风.糖尿病视网膜病变激光治疗的时机与方法[J].眼科研究, 2007, 25(6):401-403.
3. Vogel M, Schäfer FP, Stuke M, et al. Animal experiments for the determination of an optimal wavelength for retinal coagulations[J]. Graefe's Arch Clin Exp Ophthalmol, 1989, 227(3):277-280.
4. Early Treatment Diabetic Retinopathy Study Research Group. Fundus photographic risk factor for progression of diabetic retinopathy:ETDRS report number 12[J]. Ophthalmology, 1991, 98 Suppl 5:S823-833.
5. 田蓓, 魏文斌, 朱晓青, 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.
6. Tso MOM. Retinal photocoagulation therapy:clinical application and biological basis of therapeutic effects[M]//Tso MOM.Retinal disease.Philadelphia:J.B. Lippincott Company, 1988:247-250.
7. The Early Treatment Diabetic Retinopathy Study Research Group. Techniques for scatter and local photocoagulation treatment of diabetic retinopathy:ETDRS report number 3[J]. Int Ophthalmol Clin, 1987, 27(4):254-264.
8. 惠玲, 师晓丽, 王雨生, 等.倍频532 nm激光治疗糖尿病视网膜病变50例[J].国际眼科杂志, 2003, 3(4):46-48.
9. Nagpal M, Marlecha S, Nagpal K, et al. Comparison of laser photocoagulation for diabetic retinopathy using 532 nm standard laser versus multispot pattern scan laser[J]. Retina, 2010, 30(3):452-458.
10. Muqit MM, Gray JC, Marcellino GR. In vivo laser-tissue interactions and healing responses from 20-vs 100-millisecond pulse Pascal photocoagulation burns[J]. Arch Ophthalmol, 2010, 128(4):448-455.
11. Muqit MM, Denniss J, Nourrit V, et al. Spatial and spectral imaging of retinal laser photocoagulation burns[J]. Invest Ophthalmol Vis Sci, 2011, 52(2):994-1002.
12. 彭志华, 程谷萌, 吴岚. PASCAL模式扫描光凝治疗糖尿病视网膜病变的疗效观察[J].国际眼科杂志, 2013, 13(8):1639-1641.
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.
14. Mahiul MK, Muqit MM, Sanghvi C, et al. Study of clinical applications and safety for Pascal^® laser photocoagulation in retinal vascular disorders[J]. Acta Ophthalmol, 2012, 90(2):155-161.
15. Velez-Montoya R, Guerrero-Naranjo JL, Gonzalez-Mijares CC, et al. Pattern scan laser photocoagulation:safety and complications, experience after 1301 consecutive cases[J]. Br J Ophthalmol, 2010, 94(6):720-724.
16. Muqit MM, Marcellino GR, Henson DB, et al. Single-session vs. multiplesession pattern scanning laser panretinal photocoagulation in proliferative diabetic retinopathy:the Manchester Pascal Study[J]. Arch Ophthalmol, 2010, 128(5):525-533.
17. 田蓓.糖尿病视网膜病变全视网膜光凝治疗的几个问题[J].眼科, 2014, 23(4):222-225.

Chinese Journal of Ocular Fundus Diseases

Comparison of the efficacy of multi-point or single-point mode of 577 nm laser in the treatment of diabetic retinopathy

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