Central retinal thickness following panretinal photocoagulation using a multispot semi‐automated pattern‐scanning laser to treat ischaemic diabetic retinopathy: Treatment in one session compared with four monthly sessions

Abstract

PurposeTo compare central retinal thickness (CRT) after panretinal photocoagulation (PRP) with a multispot semi‐automated PAttern‐SCAnning Laser (PASCAL) in one session (SS‐PRP) versus four monthly sessions (MS‐PRP) in diabetic retinopathy.MethodsMulticentre, prospective, randomized, single‐blinded, controlled trial evaluating the noninferiority of SS‐PRP versus MS‐PRP for CRT measured with macular spectral‐domain optical coherence tomography (SD‐OCT), with a 9‐month follow‐up in patients presenting severe nonproliferative diabetic retinopathy (DR) or mild proliferative DR without macular oedema (ME) at baseline.ResultsNinety‐seven eyes of 97 participants with a mean age of 57.0 ± 14.2 years were included. The mean change of CRT from baseline to 9 months was not statistically different in SS‐PRP or in MS‐PRP: +16.9 ± 28.3 μm versus +24.7 ± 31.8 μm, respectively (p = 0.224). The variation in mean best‐corrected visual acuity (BCVA) from baseline to 9 months was similar in both groups: −1.1 ± 6.5 letters versus −0.6 ± 6.2 letters (p = 0.684). The number of patients with stabilization of DR was not statistically different between the two groups. No severe complication was recorded in either group.ConclusionThis study showed the noninferiority of PRP performed in one session versus four monthly sessions with a PASCAL concerning central retinal thickness for treating mild proliferative or severe nonproliferative DR without ME at baseline.

Comparison of Chorioretinal Parameters in Diabetic Retinopathy with or without Pan-Retinal Photocoagulation Using Ultrawide-Field Swept-Source Optical Coherence Tomography Angiography

“…The Manchester study found a significant increase in central subfield retinal thickness after PRP through follow-up [16]. Gabrielle et al found that central subfield retinal thickness increased slightly with time effect during the follow-up [17]. In this study, we also found a slight increase in retinal thickness at the macular grid in eyes with PRP compared to eyes without PRP.…”

Intravitreal anti-vascular endothelial growth factor, laser photocoagulation, or combined therapy for diabetic macular edema: A systematic review and network meta-analysis

“…Although intravitreal injection of anti-VEGF agents has been the standard therapy for DME, LP treatment is still often used ( 2 ). LP therapy is associated with severe vision loss ( 36 ). With the development of novel LP technologies, these adverse effects have reduced ( 37 ).…”

Effect of pattern scanning laser on macular thickness in diabetic retinopathy

“…This study found no significant difference in CMT between conventional and PASCAL PRP. 10 However, it only examined patients without macular edema at baseline. While this provides valuable data on the rate and magnitude of macular edema formation after PRP, from these data we cannot assess the effect PRP may have on existing macular edema and is not generalizable to patients with macular edema, which is common in PDR.…”