Panretinal Photocoagulation for Proliferative Diabetic Retinopathy: Pattern Scan Laser Versus Argon Laser
Panretinal Photocoagulation for Proliferative Diabetic Retinopathy: Pattern Scan Laser Versus Argon Laser
复制标题
DOI：
10.1016/j.ajo.2011.05.035
复制
发表时间：
2012-01-01
影响因子：
4.2
通讯作者：
Kaiser, Peter K.
中科院分区：
文献类型：
--
作者：
Chappelow, Aimee V.;Tan, Kevin;Kaiser, Peter K.
目的：评价模式扫描激光(PASCAL)治疗新诊断的高危增殖性糖尿病视网膜病变(PDR)的疗效。设计：回顾性对照病例系列。研究人群：相同数量的新诊断的高危PDR患者的82只连续眼睛接受了全视网膜光凝(PRP)治疗，其中41只眼在2007年2月之前接受了氩绿激光治疗，41只眼在2007年2月或之后接受了PASCAL治疗，然后进行了至少6个月的随访。程序：回顾图表，注意主要结果指标、年龄、性别、种族、随访间隔、胰岛素依赖性、血红蛋白A1c和激光点数。主要观察指标：新生血管的持续或复发、玻璃体出血(VH)、虹膜新生血管(NVI)、新生血管性青光眼(NVG)以及是否需要玻璃体切除。结果：接受PASCAL和Ar激光治疗的患者获得的光斑数目相似(1438对1386；P=.59)。接受PASCAL治疗的患者更有可能在最初治疗的6个月内经历新生血管的持续或复发(73%对34%；P<；.0008)。这项研究没有足够的动力来检测玻璃体出血、NVI、NVG的发生率或是否需要玻璃体切割。结论：当使用传统的激光设置时，在以前未治疗的高危PDR的情况下，使用PASCAL进行的PRP在影响视网膜新生血管的持久消退方面不如使用传统的Ar激光进行的有效。当使用帕斯卡模式激光治疗高危PDR时，医生可能需要改变治疗参数。《眼科杂志》2012；153：137-142。(C)2012年由Elsevier Inc.保留所有权利。)
PURPOSE: To evaluate the efficacy of the pattern scan laser (PASCAL) in treating newly diagnosed high-risk proliferative diabetic retinopathy (PDR).DESIGN: Retrospective comparative case series.METHODS: SETTING: Institutional. STUDY POPULATION: Eighty-two consecutive eyes of the same number of patients with newly diagnosed high-risk PDR treated with panretinal photocoagulation (PRP) using either argon green laser (41 eyes treated before February 2007) or PASCAL (41 eyes treated February 2007 or thereafter), then followed for at least 6 months. PROCEDURE: Retrospective chart review with attention to main outcome measures, age, sex, race, follow-up interval, insulin dependence, hemoglobin A1c, and total number of lasers spots. MAIN OUTCOME MEASURES: Persistence or recurrence of neovascularization, incidence of vitreous hemorrhage (VH), neovascularization of the iris (NVI), neovascular glaucoma (NVG), and need for vitrectomy.RESULTS: Patients treated with the PASCAL and argon laser received a similar number of spots (1438 vs 1386; P = .59). Patients treated with the PASCAL were more likely to experience persistence or recurrence of neovascularization within 6 months of initial treatment (73% vs 34%; P < .0008). The study was not adequately powered to detect a significant difference in incidence of vitreous hemorrhage, NVI, NVG, or need for vitrectomy.CONCLUSIONS: When using traditional laser settings, PRP performed with the PASCAL is less effective than that performed with traditional argon laser in effecting lasting regression of retinal neovascularization in the setting of previously untreated high-risk PDR. Physicians may need to change treatment parameters when using PASCAL pattern laser therapy for high-risk PDR. (Am J Ophthalmol 2012;153:137-142. (C) 2012 by Elsevier Inc. All rights reserved.)