Ye Haiyun, Yu Minzhong, Lu Lin, Jin Chenjin, Luo Guangwei
State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-Sen University, No. 54 South Xianlie Road, Guangzhou, Guangdong, 510060, China.
Department of Ophthalmology, Shanghai Children's Hospital, Shanghai Jiao Tong University, Shanghai, 200060, China.
Lasers Med Sci. 2018 Jul;33(5):1095-1102. doi: 10.1007/s10103-018-2474-0. Epub 2018 Mar 15.
Panretinal photocoagulation (PRP) is a standard method for proliferative diabetic retinopathy (PDR) treatment. However, conventional PRP usually significantly damages the retinal structure and vision. Retinal pattern scanning laser (PASCAL) photocoagulation has emerged as a new technique with fewer complications for the treatment of retinal disorders. This study compares the therapeutic effects of short-pulse PASCAL to conventional single-spot PRP for PDR. Fifty-two PDR patients (104 eyes) were randomly assigned into a short-pulse PASCAL-PRP treatment (SP) group and a conventional PRP treatment (TP) group. The best corrected visual acuity (BCVA) and full-field flash electroretinogram (ERG) data were evaluated before and after the two treatments. The BCVA data between before and after the PRP treatments did not show any significant difference. After the PRP treatment, the b-wave amplitude (b-A) in the dark-adapted 3.0 ERG (p = 0.0005) and the amplitude in the light-adapted 3.0 flicker ERG (p = 0.009) were significantly higher in the SP group compared with that of the TP group. In addition, after the PRP treatment, the a-wave implicit time (a-T) of light-adapted 3.0 ERG prolonged significantly in the TP group compared to the SP group. Compared with the parameters before the treatments, the a-A and b-A under dark-adapted 3.0 ERG and the b-A under the light-adapted 3.0 ERG in both TP and SP groups after the treatments decreased significantly (p < 0.05). Short-pulse PASCAL-PRP significantly attenuated partial vision damage compared to conventional PRP, although it still caused limited retinal injury and mild reduction in retinal function. These findings suggest that short-pulse PASCAL-PRP is a promising technique for PDR treatment.
全视网膜光凝（PRP）是治疗增殖性糖尿病视网膜病变（PDR）的标准方法。然而，传统的PRP通常会严重损害视网膜结构和视力。视网膜模式扫描激光（PASCAL）光凝作为一种治疗视网膜疾病并发症较少的新技术应运而生。本研究比较了短脉冲PASCAL与传统单点PRP治疗PDR的疗效。52例PDR患者（104只眼）被随机分为短脉冲PASCAL-PRP治疗（SP）组和传统PRP治疗（TP）组。在两种治疗前后评估最佳矫正视力（BCVA）和全视野闪光视网膜电图（ERG）数据。PRP治疗前后的BCVA数据没有显示出任何显著差异。PRP治疗后，SP组暗适应3.0 ERG中的b波振幅（b-A）（p = 0.0005）和明适应3.0闪烁ERG中的振幅（p = 0.009）显著高于TP组。此外，PRP治疗后，TP组明适应3.0 ERG的a波潜伏时间（a-T）与SP组相比显著延长。与治疗前的参数相比，TP组和SP组治疗后暗适应3.0 ERG下的a-A和b-A以及明适应3.0 ERG下的b-A均显著降低（p < 0.05）。与传统PRP相比，短脉冲PASCAL-PRP显著减轻了部分视力损害，尽管它仍然会导致有限的视网膜损伤和视网膜功能轻度下降。这些发现表明，短脉冲PASCAL-PRP是一种有前景的PDR治疗技术。
