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K. Yoneda, K. Kojima, H. Koizumi, T. Yasuhara, S. Kinoshita; Visual Acuity and Macular Thickness in Patients Treated With Short-Duration Photocoagulation for Diabetic Retinopathy. Invest. Ophthalmol. Vis. Sci. 2009;50(13):197.
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To report visual acuity (VA) and central macular thickness changes in a series of patients with diabetic retinopathy treated with short-duration photocoagulation (SDPC) versus those treated with normal-duration photocoagulation (NDPC).
Eighteen eyes of 9 patients with pre-proliferative or proliferative diabetic retinopathy who had not been previously treated were treated with pan-retinal photocoagulation (PC). This study was approved by the Institutional Review Board (IRB), and previous written informed consent was obtained from all subjects. Multi-color PC was used for the pan-retinal PC, and the common PC setting (yellow color, 450-µm diameter, 300 shots per day, every 2 weeks, 4 times) was used for both groups. The right eye of each patient was treated with SDPC (0.05 seconds, 350 mW) and the left eye was treated with NDPC (0.2 seconds, 200 mW). Macular thickness obtained by optical coherence tomography (OCT) and VA were measured at the time of each procedure and at each subsequent follow-up.
The mean age of the patients was 64 years (range: 54-78 years). Disease etiology was pre-proliferative diabetic retinopathy in 12 cases (67%) and proliferative retinopathy in 6 cases (33%). The mean follow-up period was 21 weeks (range: 10-36 weeks). Pre-treatment macular thickness in the SDPC and NDPC groups was 212 ± 26.9µm and 213 ± 28.3µm (p = 0.93), respectively. Post-treatment macular thickness of the NDPC group (252 ± 37.2 µm) was significantly thicker than that of SDPC group (194 ± 32.8µm) (p = 0.003). Pre- and post-treatment logMAR VA for the SDPC group was maintained (pre: 0.14 ± 0.27, post: 0.14 ± 0.23, p = 0.50). Whereas pre- and post-treatment logMAR VA for the NDPC group was significantly decreased (pre: 0.05 ± 0.15, post: 0.13 ± 0.13, p = 0.03). All patients experienced less pain with SDPC than with NDPC.
The use of SDPC results in a significantly lower incidence of macular edema and VA decrease than traditional PC. Pan-retinal PC using SDPC has few side-effects, such as macular edema, visual dysfunction, and pain.
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