Hamed Nadine, Vander Woude Logan, Roohipourmoallai Ramak, Ohning Collin, Regan Kathleen A, Iyer Siva S R
Department of Ophthalmology, College of Medicine, University of Florida, Gainesville, FL, USA.
Associate Professor, Department of Ophthalmology, College of Medicine , University of Florida, 1600, SW Archer Road, Gainesville FL, 32610, USA.
Ther Adv Ophthalmol. 2021 Aug 12;13:25158414211035860. doi: 10.1177/25158414211035860. eCollection 2021 Jan-Dec.
This study investigates the effect of pattern scanning laser (PASCAL) panretinal photocoagulation (PRP) on central macular thickness (CMT) and visual acuity (VA) in patients with proliferative diabetic retinopathy (PDR).
This retrospective non-randomized comparative case series included 262 eyes (163 with macular edema) of 177 patients with PDR. Treatment was PRP alone (137), PRP + anti-vascular endothelial growth factor (VEGF) (69), PRP + focal laser (28), or all three (89). CMT and central macular volume 3 and 6 mm from fovea were analyzed before and 1, 3, and 6 months after PRP. Spot number was plotted against CMT, and linear regression analysis was performed.
For each treatment group and time point, there was a non-significant relationship between spot number and CMT. In eyes receiving all three treatment modalities, a significant negative relationship was found between spot number and 3-mm volume at 6 months ( = 0.04) and 6-mm volume at 1 month ( = 0.002) and 6 months ( = 0.011). There was no significant change in VA in any treatment group at the 6-month time point.
PASCAL PRP ± focal laser or anti-VEGF was not associated with increased development of macular edema or change in VA. PASCAL PRP with focal laser and anti-VEGF may result in a decrease in macular edema.
本研究调查模式扫描激光(PASCAL)全视网膜光凝(PRP)对增殖性糖尿病视网膜病变(PDR)患者中心黄斑厚度(CMT)和视力(VA)的影响。
本回顾性非随机对照病例系列研究纳入了177例PDR患者的262只眼(163只眼有黄斑水肿)。治疗方式包括单纯PRP(137只眼)、PRP联合抗血管内皮生长因子(VEGF)(69只眼)、PRP联合局部激光(28只眼)或三者联合(89只眼)。在PRP治疗前以及治疗后1、3和6个月分析CMT以及距黄斑中心凹3和6毫米处的中心黄斑体积。将光斑数量与CMT进行绘图,并进行线性回归分析。
对于每个治疗组和时间点,光斑数量与CMT之间均无显著相关性。在接受所有三种治疗方式的眼中,发现光斑数量与6个月时3毫米处体积(P = 0.04)、1个月时6毫米处体积(P = 0.002)以及6个月时6毫米处体积(P = 0.011)之间存在显著负相关。在6个月时间点,任何治疗组的VA均无显著变化。
PASCAL PRP联合或不联合局部激光或抗VEGF治疗与黄斑水肿的增加或VA的变化无关。PASCAL PRP联合局部激光和抗VEGF治疗可能会导致黄斑水肿减轻。