Cole Eye Institute, Cleveland Clinic, Cleveland, Ohio, USA.
Am J Ophthalmol. 2012 Jan;153(1):137-42.e2. doi: 10.1016/j.ajo.2011.05.035. Epub 2011 Sep 19.
To evaluate the efficacy of the pattern scan laser (PASCAL) in treating newly diagnosed high-risk proliferative diabetic retinopathy (PDR).
Retrospective comparative case series.
Institutional.
Eighty-two consecutive eyes of the same number of patients with newly diagnosed high-risk PDR treated with panretinal photocoagulation (PRP) using either argon green laser (41 eyes treated before February 2007) or PASCAL (41 eyes treated February 2007 or thereafter), then followed for at least 6 months.
Retrospective chart review with attention to main outcome measures, age, sex, race, follow-up interval, insulin dependence, hemoglobin A1c, and total number of lasers spots.
Persistence or recurrence of neovascularization, incidence of vitreous hemorrhage (VH), neovascularization of the iris (NVI), neovascular glaucoma (NVG), and need for vitrectomy.
Patients treated with the PASCAL and argon laser received a similar number of spots (1438 vs 1386; P = .59). Patients treated with the PASCAL were more likely to experience persistence or recurrence of neovascularization within 6 months of initial treatment (73% vs 34%; P < .0008). The study was not adequately powered to detect a significant difference in incidence of vitreous hemorrhage, NVI, NVG, or need for vitrectomy.
When using traditional laser settings, PRP performed with the PASCAL is less effective than that performed with traditional argon laser in effecting lasting regression of retinal neovascularization in the setting of previously untreated high-risk PDR. Physicians may need to change treatment parameters when using PASCAL pattern laser therapy for high-risk PDR.
评估模式扫描激光（PASCAL）治疗新诊断的高危增殖性糖尿病视网膜病变（PDR）的疗效。
回顾性比较病例系列。
机构。
82 只连续眼，均为同一数量的新诊断为高危 PDR 的患者，这些患者接受全视网膜光凝（PRP）治疗，其中 41 只眼在 2007 年 2 月之前接受氩绿激光治疗（治疗前），41 只眼在 2007 年 2 月或之后接受 PASCAL 治疗，然后至少随访 6 个月。
回顾性图表审查，主要关注主要结局指标、年龄、性别、种族、随访间隔、胰岛素依赖、血红蛋白 A1c 和总激光点数。
新生血管的持续存在或复发、玻璃体积血（VH）的发生率、虹膜新生血管（NVI）、新生血管性青光眼（NVG）和玻璃体切除术的需要。
接受 PASCAL 和氩激光治疗的患者接受的激光点数相似（1438 与 1386；P =.59）。接受 PASCAL 治疗的患者在初始治疗后 6 个月内新生血管持续存在或复发的可能性更高（73%比 34%；P <.0008）。本研究没有足够的效力来检测玻璃体积血、NVI、NVG 或玻璃体切除术需要的发生率的显著差异。
在使用传统激光设置时，PASCAL 进行的 PRP 在治疗未经治疗的高危 PDR 时，视网膜新生血管的持久消退效果不如传统氩激光治疗。当使用 PASCAL 模式激光治疗高危 PDR 时，医生可能需要改变治疗参数。
