Abstract
Objective:To compare the change in central subfield macular thickness following single-session and multiple-session laser panretinal photocoagulation in subjects with diabetic retinopathy.Methods:A single-center, randomized controlled trial study was performed on 28 eyes of 16 patients with severe non-proliferative diabetic retinopathy or proliferative diabetic retinopathy. Eyes were randomly assigned for treatment with panretinal photocoagulation performed either in single-session or multiple-session divided into three sessions during two-week period. Central subfield macular thickness was quantified using spectral domain optical coherence tomography and changes at four weeks follow-up were compared to the baseline measurement.Result:Mean baseline central subfield macular thickness of 12 eyes underwent single-session and 16 eyes underwent multiple-session panretinal photocoagulation were 342.91+109.51 micrometers and 354+171.79 micrometers (p> .05), respectively. Mean post laser central subfield macular thickness in the single-session group was 305.83+81.95 micrometers and 389.75+229.51 micrometers in the multiple-session group (p> .05). Mean central subfield macular thickness changes four weeks post laser was 37.08+94.21 micrometers for eyes treated with single-session and -35.75+123.62 micrometers for the multiple-session treated eyes (p= .101).Conclusion:There was no significant difference in change of central subfield macular thickness at four weeks post laser from treatment with single-session and multiple-session panretinal photocoagulation. Single-session panretinal photocoagulation can be used as effective multiple-session panretinal photocoagulation for the treatment of diabetic retinopathy.
Highlights
Diabetic Retinopathy (DR) is the most common blinding microvascular complication of diabetes mellitus
Laser treatment is generally accepted as the gold standard and mainstay therapy for severe Non Proliferative Diabetic Retinopathy (NPDR) and Proliferative Diabetic Retinopathy (PDR) since the studies on DR were established
Laser panretinal (scatter) Photocoagulation (PRP) has been shown to reduce the risk of severe visual loss in severe NPDR and PDR, there might be concern that the progression of diabetic macular edema can occur after PRP, leading to decrease in visual acuity [3, 6, 13]
Summary
Diabetic Retinopathy (DR) is the most common blinding microvascular complication of diabetes mellitus. It is a growing problem as the number of people with diabetes increases. The use of laser photocoagulation in treating diabetic retinopathy has gained universal acceptance in ophthalmology practices since its introduction by Meyer-Schwikerath in. The sessions are painful, costly, time-consuming, and require patient’s compliance, which is tiring for both patients and doctors. In another hand, the single-session procedure has been associated with increased complications such as retinal detachment and vision-disabling macular edema [1, 5 - 7]
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