Retinal and Choroidal Alterations in Diabetic Retinopathy Treatment using Subthreshold Panretinal Photocoagulation with Endpoint Management Algorithm: A Secondary Analysis of a Randomized Clinical Trial

医学 糖尿病性视网膜病变 眼科 视网膜 临床终点 随机对照试验 帕斯卡(单位) 冷冻疗法 全视网膜光凝术 阈下传导 血管性 糖尿病 外科 内分泌学 物理 晶体管 量子力学 电压
作者
Zijing Li,Tu Lu,Lijun Zhou,Chuangxin Huang,Hongkun Zhao,Jiandong Liang,Cong Li,Qifeng Cong,Yuqing Lan,Chenjin Jin
出处
期刊:Ophthalmology and therapy [Springer Nature]
卷期号:12 (4): 1867-1880
标识
DOI:10.1007/s40123-023-00713-0
摘要

The aim of this study was to compare retinal and choroidal alterations in eyes with severe nonproliferative diabetic retinopathy (NPDR) after panretinal photocoagulation (PRP), using conventional pattern scan laser (PASCAL) and PASCAL with endpoint management (EPM).This was a post hoc analysis of a paired randomized clinical trial. Bilateral treatment-naïve eyes of an individual with symmetric severe NPDR were randomly allocated into the threshold PRP group and subthreshold EPM PRP group. Patients had follow-up visits at 1, 3, 6, 9, and 12 months post-treatment. The retinal thickness (RT), choroidal thickness (CT), choroidal area, and choroidal vascularity index (CVI) were compared between the two groups and among different time points within the same group.Seventy eyes of 35 patients with diabetes mellitus (DM) were finally included for analysis at the 6- and 12-month visits, respectively. At 3 and 6 months post-treatment, the RT in the subthreshold EPM PRP group was significantly thinner than that in the threshold PRP group. CT, stromal area, and luminal area were reduced earlier in the threshold PRP group than in the subthreshold EPM PRP group. CVI was not significantly different within the same group or between groups at most time points.At 12 months post-treatment, retinal thickening and choroidal disturbance may be slightly less severe and more delayed in eyes receiving PRP using PASCAL with EPM than in those receiving PRP using conventional PASCAL. The EPM algorithm may be a good alternative in PRP when treating severe NPDR.ClinicalTrials.gov identifier, NCT01759121.
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