One-year outcomes of panretinal photocoagulation in proliferative diabetic retinopathy

Kaiser, Richard; Maguire, Maureen G.; Grunwald, Juan E.; Lieb, Douglas F.; Jani, Binoy R.; Brucker, Alexander J.; Maguire, Albert M.; Ho, Allen C.; Fine, Stuart L.

doi:10.1016/s0002-9394(99)00322-0

Cited by 41 publications

(53 citation statements)

References 8 publications

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“…Although higher than the ETDRS vitrectomy incidence of 5.6%, our 17% vitrectomy incidence (10% for non-clearing vitreous haemorrhage) is within the range reported in contemporary studies. 28,37 Consistent with the observations of the DRS, ETDRS, and subsequent studies, the most common clinical response to SDM PRP was arrest or regression and fibrosis of neovascularization rather than disappearance. Compared to our experience with conventional PRP, the response to SDM PRP developed more gradually and without marked contraction of the neovascular tissue.…”

Section: Discussionsupporting

confidence: 68%

“…19,[23][24][25][26][27] Like previous studies of PRP for PDR, overall visual acuity was unchanged. [28][29][30] However, the proportion of eyes with excellent visual acuity of 20/30 or better visual acuity increased from 39 to 48% during the course of the study, possibly due to avoidance of treatment complications that can reduce visual acuity postoperatively.…”

Section: Discussionmentioning

confidence: 98%

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Subthreshold diode micropulse panretinal photocoagulation for proliferative diabetic retinopathy

Luttrull

Musch

Spink

2007

Eye

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Section: Discussionsupporting

confidence: 68%

Section: Discussionmentioning

confidence: 98%

Subthreshold diode micropulse panretinal photocoagulation for proliferative diabetic retinopathy

Luttrull

Musch

Spink

2007

Eye

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“…This is broadly similar to rates of 6 and 17% reported in other studies. 14,15 The rates of new VH, new TRD, and new rubeosis in this study were lower than the national audit, but the vitrectomy rate was significantly higher (7.5 vs 1.5%, P ¼ 0.02 w 2 ). This is partly due to our policy of performing early vitrectomy, and also of performing initial PRP in high-risk cases at presentation, prior to a planned vitrectomy.…”

Section: Discussioncontrasting

confidence: 61%

“…In another large study comprising 297 patients, the vitrectomy rate at 1 year was 10%, which is comparable to our rate of 7.5% at 9.4 months. 14 The timing of vitrectomy continues to be controversial, and the respective roles of continued observation vs augmentation laser therapy or early vitrectomy have not yet been clearly defined. 15 The limitations of this study include all those associated with a retrospective study.…”

Section: Discussionmentioning

confidence: 99%

Routine, single session, indirect laser for proliferative diabetic retinopathy

Tinley

Gray

2009

Eye

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Aims To evaluate the visual and morphological outcomes of routine, single session, indirect panretinal photocoagulation (PRP) for proliferative diabetic retinopathy, and to examine adverse events related to indirect laser within the first 8 weeks of treatment. Methods The case notes of 107 diabetics with proliferative retinopathy undergoing indirect PRP were reviewed retrospectively, and compared with the UK National Diabetic Retinopathy Laser Treatment Audit. Patients who had received PRP previously were excluded. Follow-up data were collected as close as possible to 9 months following the initial laser treatment. Results Fifteen patients (14.0%) returned with adverse events within the first 8 weeks of indirect PRP. There were two tractional retinal detachments and two new vitreous haemorrhages. One patient with underlying neurotrophic keratopathy developed a persistent epithelial defect. One developed non-progressive macular drag with a one-line drop in Snellen acuity. Three experienced new or exacerbations of preexisting clinically significant macular oedema, which resolved spontaneously. There were two transient choroidal effusions, two transient anterior uveitis, and two transient visual deteriorations without macular oedema clinically. There were no significant differences in the rates of new tractional retinal detachment, vitreous haemorrhage or rubeosis, but our vitrectomy rate was higher (7.5 vs 1.5%, P ¼ 0.02, v 2 ), largely due to our policy of performing vitrectomy early. Conclusions Visual and morphological outcomes of routine, single session, indirect PRP for proliferative diabetic retinopathy were not inferior to the outpatient-based national audit, and the incidence of significant PRP-induced adverse events was low.

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“…1,2 Longer-term reports including a DRS cohort study showed that the effectiveness of PRP treatment is dose related, and supplemental 'top-up' PRP is often required following primary treatment in order to achieve complete disease regression. [3][4][5] In the United Kingdom, a Department of Health-funded National Diabetic Retinopathy Laser Treatment Audit evaluated PRP laser delivery in 1995, and reported that the clinical and visual outcomes is dependent on the surface area ablated with PRP laser. 6,7 In current clinical practice, the parameters for PRP are evolving, with shorter pulse duration laser settings being used.…”

Section: Introductionmentioning

confidence: 99%

Pascal panretinal laser ablation and regression analysis in proliferative diabetic retinopathy: Manchester Pascal Study Report 4

Muqit

Marcellino

Henson

et al. 2011

Eye

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Aims To quantify the 20-ms Pattern Scan Laser (Pascal) panretinal laser photocoagulation (PRP) ablation dosage required for regression of proliferative diabetic retinopathy (PDR), and to explore factors related to long-term regression. Methods We retrospectively studied a cohort of patients who participated in a randomised clinical trial, the Manchester Pascal Study. In all, 36 eyes of 22 patients were investigated over a follow-up period of 18 months. Primary outcome measures included visual acuity (VA) and complete PDR regression. Secondary outcomes included laser burn dosimetry, calculation of retinal PRP ablation areas, and effect of patient-related factors on disease regression. A PDR subgroup analysis was undertaken to assess all factors related to PDR regression according to disease severity. Results There were no significant changes in logMAR VA for any group over time. In total, 10 eyes (28%) regressed after a single PRP. Following top-up PRP treatment, regression rates varied according to severity: 75% for mild PDR (n ¼ 6), 67% for moderate PDR (n ¼ 14), and 43% in severe PDR (n ¼ 3). To achieve complete disease regression, mild PDR required a mean of 2187 PRP burns and 264 mm 2 ablation area, moderate PDR required 3998 PRP burns and area 456 mm 2 , and severe PDR needed 6924 PRP laser burns (836 mm 2 ; Po0.05). Conclusions Multiple 20-ms PRP treatments applied over time does not adversely affect visual outcomes, with favourable PDR regression rates and minimal laser burn expansion over 18 months. The average laser dosimetry and retinal ablation areas to achieve complete regression increased significantly with worsening PDR.

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One-year outcomes of panretinal photocoagulation in proliferative diabetic retinopathy

Cited by 41 publications

References 8 publications

Subthreshold diode micropulse panretinal photocoagulation for proliferative diabetic retinopathy

Subthreshold diode micropulse panretinal photocoagulation for proliferative diabetic retinopathy

Routine, single session, indirect laser for proliferative diabetic retinopathy

Pascal panretinal laser ablation and regression analysis in proliferative diabetic retinopathy: Manchester Pascal Study Report 4

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