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07.09.2022 | Original Article

Comparison of functional changes of retina after subthreshold and threshold pan-retinal photocoagulation in severe non-proliferative diabetic retinopathy

verfasst von: Hongkun Zhao, Lijun Zhou, Kunbei Lai, Minzhong Yu, Chuangxin Huang, Fabao Xu, Cong Li, Lin Lu, Chenjin Jin

Erschienen in: Lasers in Medical Science | Ausgabe 9/2022

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Abstract

Purpose

To find a new approach of pan-retinal photocoagulation (PRP) with less damage to the retina in the treatment of severe non-proliferative diabetic retinopathy (NPDR), this study compared functional changes in the retina after subthreshold and threshold PRP treatment in severe NPDR eyes.

Methods

Post hoc analysis of a randomized clinical trial was conducted in this study. Seventy eyes of 35 patients with bilateral, symmetric, severe NPDR were enrolled. Two eyes from the same patient were randomized into two groups, one eye received subthreshold PRP (S-PRP) and the other eye received threshold PRP (T-PRP). Comprehensive ophthalmological evaluations were performed on the baseline and every 3 months for 1 year. Visual field (VF) and full-field electroretinography (ERG) were performed on the baseline and repeated at month 12.

Results

During the 12-month follow-up, 4 eyes (11.4%) in the S-PRP group and 3 eyes (8.6%) in the T-PRP group progressed to proliferative diabetic retinopathy (PDR) stage, and there was no statistical difference in PDR progression rate between the two groups (P = 0.69). In addition, the changes in best-corrected visual acuity (BCVA) from baseline to month 12 between the two groups had no statistical difference (P = 0.30). From baseline to month 12, changes in central VF between the two groups had no statistical difference (P = 0.25), but changes in total score points of peripheral VF in the S-PRP group (− 242.1 ± 210.8 dB) and the T-PRP group (− 308.9 ± 209.7 dB) were statistically significant (P = 0.03). At month 12, ERG records showed that the amplitude of dark-adapted 0.01 ERG, dark-adapted 3.0 ERG, oscillatory potentials, light-adapted 3.0 ERG, and 30 Hz flicker ERG of both groups were significantly decreased from the baseline (P < 0.05). In addition, the amplitude of each ERG record in the S-PRP group decreased significantly less than those in the T-PRP group (P < 0.05).

Conclusions

Subthreshold PRP is as effective as threshold PRP for preventing severe NPDR progress to PDR within 1 year with less damage to periphery VF and retinal function.

Trial registration.

ClinicalTrials.gov Identifier: NCT01759121.

Klein BEK (2007) Overview of epidemiologic studies of diabetic retinopathy. In: Ophthalmic epidemiology. Ophthalmic Epidemiol, pp 179–183

Flaxel CJ, Adelman RA, Bailey ST et al (2020) Diabetic Retinopathy Preferred Practice Pattern®. Ophthalmology 127:P66–P145. https://doi.org/10.1016/j.ophtha.2019.09.025CrossRefPubMed

(1991) Early photocoagulation for diabetic retinopathy: ETDRS Report Number 9. Ophthalmology. https://doi.org/10.1016/S0161-6420(13)38011-7

Blumenkranz MS, Yellachich D, Andersen DE et al (2006) Semiautomated patterned scanning laser for retinal photocoagulation. Retina 26:370–376. https://doi.org/10.1097/00006982-200603000-00024CrossRefPubMed

At J, Blumenkranz MS, Paulus Y et al (2008) Effect of pulse duration on size and character of the lesion in retinal photocoagulation. Arch Ophthalmol 126:78–85. https://doi.org/10.1001/archophthalmol.2007.29CrossRef

Muqit MMK, Young LB, McKenzie R et al (2013) Pilot randomised clinical trial of Pascal TargETEd Retinal versus variable fluence PANretinal 20 ms laser in diabetic retinopathy: PETER PAN study. Br J Ophthalmol 97:220–227. https://doi.org/10.1136/bjophthalmol-2012-302189CrossRefPubMed

Muqit MMK, Marcellino GR, Henson DB et al (2010) Single-session vs multiple-session pattern scanning laser panretinal photocoagulation in proliferative diabetic retinopathy: The Manchester Pascal study. Arch Ophthalmol 128:525–533. https://doi.org/10.1001/archophthalmol.2010.60CrossRefPubMed

Muqit MMK, Marcellino GR, Henson DB et al (2011) Randomized clinical trial to evaluate the effects of pascal panretinal photocoagulation on macular nerve fiber layer: Manchester pascal study report 3. Retina 31:1699–1707. https://doi.org/10.1097/IAE.0b013e318207d188CrossRefPubMed

Muqit MMK, Marcellino GR, Gray JCB et al (2010) Pain responses of Pascal 20 ms multi-spot and 100 ms single-spot panretinal photocoagulation: Manchester Pascal Study, MAPASS report 2. Br J Ophthalmol 94:1493–1498. https://doi.org/10.1136/bjo.2009.176677CrossRefPubMed

10.

Hamada M, Ohkoshi K, Inagaki K et al (2018) Subthreshold photocoagulation using endpoint management in the PASCAL® System for diffuse diabetic macular edema. J Ophthalmol 2018:7465794. https://doi.org/10.1155/2018/7465794CrossRefPubMedPubMedCentral

11.

Lai K, Zhao H, Zhou L et al (2020) Subthreshold pan-retinal photocoagulation using endpoint management algorithm for severe non-proliferative diabetic retinopathy: a paired controlled pilot prospective study. Ophthalmic Res. https://doi.org/10.1159/000512296CrossRefPubMed

12.

McCulloch DL, Marmor MF, Brigell MG et al (2015) ISCEV Standard for full-field clinical electroretinography (2015 update). Doc Ophthalmol 130:1–12. https://doi.org/10.1007/s10633-014-9473-7CrossRefPubMed

13.

Lavinsky D, Sramek C, Wang J, et al (2014) Subvisible retinal laser therapy: titration algorithm and tissue response. Retina. https://doi.org/10.1097/IAE.0b013e3182993edc

14.

Varma R, Torres M, Peña F et al (2004) Prevalence of diabetic retinopathy in adult Latinos: the Los Angeles Latino eye study. Ophthalmology 111:1298–1306. https://doi.org/10.1016/j.ophtha.2004.03.002CrossRefPubMed

15.

Royle P, Mistry H, Auguste P, et al (2015) Pan-retinal photocoagulation and other forms of laser treatment and drug therapies for non-proliferative diabetic retinopathy: systematic review and economic evaluation. Health Technol Assess (Rockv) 19. https://doi.org/10.3310/hta19510

16.

Vergmann AS, Grauslund J (2020) Changes of visual fields in treatment of proliferative diabetic retinopathy: a systematic review. Acta Ophthalmol 98:763–773. https://doi.org/10.1111/aos.14474CrossRefPubMed

17.

DUNCAN JL (2001) Electrophysiologic testing in disorders of the retina, optic nerve, and visual pathway. Br J Ophthalmol. https://doi.org/10.1136/bjo.85.8.1013e

18.

Tzekov R, Arden GB (1999) The electroretinogram in diabetic retinopathy. Surv Ophthalmol 44:53–60. https://doi.org/10.1016/S0039-6257(99)00063-6CrossRefPubMed

19.

Messias A, Filho JAR, Messias K et al (2012) Electroretinographic findings associated with panretinal photocoagulation (PRP) versus PRP plus intravitreal ranibizumab treatment for high-risk proliferative diabetic retinopathy. Doc Ophthalmol 124:225–236. https://doi.org/10.1007/s10633-012-9322-5CrossRefPubMed

20.

Messias K, de Barroso RM, Jorge R, Messias A (2018) Retinal function in eyes with proliferative diabetic retinopathy treated with intravitreal ranibizumab and multispot laser panretinal photocoagulation. Doc Ophthalmol 137:121–129. https://doi.org/10.1007/s10633-018-9655-9CrossRefPubMed

21.

Messias A, Ramos Filho JA, Messias K et al (2012) Electroretinographic findings associated with panretinal photocoagulation (PRP) versus PRP plus intravitreal ranibizumab treatment for high-risk proliferative diabetic retinopathy. Doc Ophthalmol 124:225–236. https://doi.org/10.1007/s10633-012-9322-5CrossRefPubMed

22.

Khojasteh H, Vishte RA, Mirzajani A et al (2020) Electroretinogram changes following sequential panretinal photocoagulation for proliferative diabetic retinopathy. Clin Ophthalmol 14:967–975. https://doi.org/10.2147/OPTH.S248678CrossRefPubMedPubMedCentral

23.

Perlman I, Gdal-on M, Miller B, Zonis S (1985) Retinal function of the diabetic retina after argon laser photocoagulation assessed electroretinographically. Br J Ophthalmol. https://doi.org/10.1136/bjo.69.4.240CrossRefPubMedPubMedCentral

Titel: Comparison of functional changes of retina after subthreshold and threshold pan-retinal photocoagulation in severe non-proliferative diabetic retinopathy
verfasst von: Hongkun Zhao
Lijun Zhou
Kunbei Lai
Minzhong Yu
Chuangxin Huang
Fabao Xu
Cong Li
Lin Lu
Chenjin Jin
Publikationsdatum: 07.09.2022
Verlag: Springer London
Erschienen in: Lasers in Medical Science / Ausgabe 9/2022
Print ISSN: 0268-8921
Elektronische ISSN: 1435-604X
DOI: https://doi.org/10.1007/s10103-022-03635-8

Springer Medizin

Abstract

Purpose

Methods

Results

Conclusions

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