Single-session vs multiple-session pattern scanning laser panretinal photocoagulation in proliferative diabetic...

Area of Science:

• Ophthalmology
• Diabetic Retinopathy Treatment
• Laser Therapy

Background:

• Proliferative diabetic retinopathy (PDR) is a severe complication of diabetes.
• Panretinal photocoagulation (PRP) is a standard treatment for PDR.
• Traditional PRP involves multiple sessions, increasing patient burden and treatment time.

Purpose of the Study:

• To compare the efficacy and safety of single-session panretinal photocoagulation (SS-PRP) with multispot laser (Pascal) versus multiple-session, single-spot PRP (MS-PRP).
• To evaluate treatment time and clinical outcomes in patients with PDR.

Main Methods:

• A single-center, randomized clinical trial involving 40 eyes with PDR.
• Treatment involved 1500 burns with a 400-µm spot size, delivered either as 20-millisecond SS-PRP or 100-millisecond MS-PRP over 3 sessions.
• Outcomes measured included visual acuity, central subfield retinal thickness (CRT), and visual fields at baseline and 4 and 12 weeks.

Main Results:

• SS-PRP showed no significant increase in CRT, unlike MS-PRP which had a significant increase (20-22 µm).
• Mean deviation in visual fields improved significantly with SS-PRP after 4 weeks.
• Positive PDR treatment effect was observed in 74% of SS-PRP eyes vs. 53% of MS-PRP eyes.
• Mean treatment time for SS-PRP was 5 minutes, significantly shorter than MS-PRP (59 minutes).

Conclusions:

• Twenty-millisecond Pascal SS-PRP is a safe and rapid alternative for PDR treatment.
• SS-PRP demonstrates comparable efficacy to conventional MS-PRP with significantly reduced treatment duration.
• No adverse outcomes related to CRT, visual acuity, or visual fields were noted at 12 weeks post-treatment.