September 2016
Volume 57, Issue 12
Open Access
ARVO Annual Meeting Abstract  |   September 2016
Functional and anatomical outcomes in patients submitted to panretinal photocoagulation using 577nm multispot vs 532nm single-spot laser: a clinical trial
Author Affiliations & Notes
  • José Belúcio-Neto
    Department of Ophthalmology and Visual Sciences, UNIFESP, São Paulo, Brazil
  • Camilla de Oliveira Xavier
    Department of Ophthalmology and Visual Sciences, UNIFESP, São Paulo, Brazil
  • Joao Rafael de Oliveira Dias
    Department of Ophthalmology and Visual Sciences, UNIFESP, São Paulo, Brazil
  • Renato Magalhaes Passos
    Department of Ophthalmology and Visual Sciences, UNIFESP, São Paulo, Brazil
  • Mauricio Maia
    Department of Ophthalmology and Visual Sciences, UNIFESP, São Paulo, Brazil
  • Andre Maia
    Department of Ophthalmology and Visual Sciences, UNIFESP, São Paulo, Brazil
  • Footnotes
    Commercial Relationships   José Belúcio-Neto, None; Camilla Xavier, None; Joao Dias, None; Renato Passos, None; Mauricio Maia, None; Andre Maia, None
  • Footnotes
    Support  None
Investigative Ophthalmology & Visual Science September 2016, Vol.57, 5856. doi:
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      José Belúcio-Neto, Camilla de Oliveira Xavier, Joao Rafael de Oliveira Dias, Renato Magalhaes Passos, Mauricio Maia, Andre Maia; Functional and anatomical outcomes in patients submitted to panretinal photocoagulation using 577nm multispot vs 532nm single-spot laser: a clinical trial. Invest. Ophthalmol. Vis. Sci. 2016;57(12):5856.

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      © ARVO (1962-2015); The Authors (2016-present)

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Abstract

Purpose : To evaluate anatomical and functional outcomes in patients with diabetic retinopathy (DR) submitted to panretinal photocoagulation (PRP) with 577nm multispot laser (Supra Scan® Quantel Medical) vs 532nm single-spot laser (PASCAL® Topcon), and to compare laser parameters and patient comfort.

Methods : Single-center, randomized clinical trial involving 48 patients with DR who met criteria for PRP. Eyes with ocular commorbidities or previous intravitreal injection or vitrectomy were excluded. Baseline best corrected visual acuity (BCVA), OCT and fluorescein angiography were performed. Patients were then submitted to PRP, either using 577nm multispot laser with 20ms exposure time (group 1) or 532nm single-spot laser with 100ms exposure time (group 2). Exams were repeated 6 months after treatment. The main outcome was BCVA, and secondary outcomes were FA and OCT changes, laser parameters, number of sessions required for PRP and patient comfort.

Results : 10 patients were excluded and 5 have not yet completed treatment. Group 1 included 15 patients; baseline mean BCVA was 0,5±0,3 and central retinal thickness (CRT) was 294,1±102,1μm; treatment was divided in 3,3±0,8 sessions, delivering 2739±616,1 spots. Patients reported discomfort during PRP as a subjective scale from 0 to 10; mean pain was 5,5±2,1 and photofobia was 5,8±2,8. After 6 months, mean BCVA was 0,5±0,2 and CRT was 243,7±59,9; OCT evidenced induction of posterior vitreous detachment (PVD) in 57,1% of patients, and macular edema improved in 71,4%. Group 2 included 18 patients; baseline mean BCVA was 0,5±0,5 and CRT was 353,1±196,4μm; 1290,9±238,9 spots were produced in 4,1±0,8 sessions; mean pain was 6,1±2,1 and photofobia was 6,0 ±2,0. In the 6-month visit, mean BVCA was 0,7±0,6; OCT showed PVD induction in 37,5% of patients, and macular edema improved in 50%. Angiographic evaluation 6 months after PRP in group 1 showed reduction of vasculitis and non-perfusion areas in 71,4% of patients and regression of new vessels in 28,7%; those numbers in group 2 were, respectively, 75% and 50%.

Conclusions : 577nm multispot laser, compared to 532nm single-spot, requires a smaller number of sessions for completing PRP (using higher treatment density), is better tolerated by patients, seems to induct PVD and to improve macular edema more frequently, and provides similar angiographic improvements.

This is an abstract that was submitted for the 2016 ARVO Annual Meeting, held in Seattle, Wash., May 1-5, 2016.

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