Long-term effects of pattern scan laser pan-retinal photocoagulation on diabetic retinopathy in Chinese patients: a retrospective study

●AIM:To evaluate the long-term effects of pattern scan laser(PASCAL)pan-retinal photocoagulation(PRP)on diabetic retinopathy(DR)in Chinese patients.●METHODS:In this retrospective study,we evaluated clinical data of 29 patients(53 eyes)with severe non-proliferative DR(SNPDR)or proliferative DR(PDR)who received PRP and follow-up at our hospital from 2008 to 2013.Sixteen patients(29 eyes)received PASCAL PRP and 13 patients(24 eyes)received 100-ms conventional laser PRP.●RESULTS:After long-term follow-up(mean,min-max days:719.8,290-1666 for PASCAL PRP vs 743.5,240-1348 for conventional PRP,P=0.569),patients receiving PASCAL PRP required fewer photocoagulation sessions than the conventional PRP group(2.6±1.0 vs 3.9±0.9,P<0.01).Best corrected visual acuity(BCVA)was reduced slightly in PASCAL PRP group while reduced significantly in conventional PRP group.At last visit,24 eyes in the PASCAL group(88.9%)and 21 eyes in the conventional group(91.7%)were improved or stable.Two eyes in PASCAL PRP group(7.4%)and 3 eyes in the conventional PRP group(12.5%)developed vitreous hemorrhage or vitreous fibrovascular proliferation.●CONCLUSION:PASCAL PRP is as effective and may be more conducive to maintaining visual acuity with less treatment sessions for DR treatment compared to conventional laser PRP.

Clinical correlation between blood glucose control-related factors and postoperative fundus hemorrhage after pan-retinal photocoagulation for diabetic retinopathy

Objective: To discuss the clinical correlation between blood glucose control-related factors and postoperative fundus hemorrhage after pan-retinal photocoagulation (PRP) for diabetic retinopathy (DR). Method: From February 2013 to January 2017, 98 patients at 7 d after PRP for DR were recruited. Depending on postoperative fundus status, the patients were divided into normal fundus group (n=42), fundus hemorrhage group (n=30) and proliferative DR group (n=27). The baseline data and monitoring data of blood glucose and blood lipid were recorded. Dynamic glucose monitor system was used to detect indicators of blood glucose fluctuation, MAGE and MBG. Result: The three groups were compared in terms of systolic pressure, diastolic pressure, course of disease, gender, age and body mass index (BMI), and no significant differences were found. As compared with the normal fundus group, the fundus hemorrhage group and proliferative DR group had a significant increase in FPG, HbA1c, 2hPG, LDL-C and TC, but a decrease in HDL-C. MAGE and MBG for the fundus hemorrhage group were (4.89±1.42) and (7.82±1.42), respectively, which were higher than those of the normal fundus group, but no significantly different from those of the proliferative DR group. Linear correlation analysis was performed in 98 patients, and significant linear correlations existed between MAGE, MBG, FPG, HbA1c and LDL-C with fundus hemorrhage. Conclusion: Blood glucose control-related factors MAGE, MBG, FPG, HbA1c and LDL-C were important influence factors of fundus hemorrhage following PRP for DR. Appropriate countermeasures are needed to reduce the fluctuation of blood glucose level.

Outcomes of vitrectomy,complete pan-retinal photocoagulation,and endoscopic cyclophotocoagulation surgery after anti-VEGF treatment in neovascular glaucoma

Purpose:To establish a comprehensive treatment strategy and evaluate the efficacy of combination of anti-vascular endothelial growth factor(VEGF)injection,pars plana vitrectomy(PPV),endoscopic pan-retinal photocoagulation(PRP),and endoscopic cyclophotocoagulation(ECP)surgery for neovascular glaucoma(NVG)patients.Methods:This retrospective study included 30 patients(30 eyes)who were suffering from NVG and treated with PPV&PRP&ECP(ECP group,16 eyes),or Ahmed glaucoma valve implantation(Ahmed group,14 eyes).The intraocular pressure(IOP),number of postoperative anti-glaucoma medications,best-corrected visual acuity(BCVA),successful rate of surgery,and postoperative complications were recorded and statistically analyzed at the time points of preoperative,1-day,1-month,3-months,6-months,and 12-months after operation.Results:An obvious reduction in IOP and number of postoperative anti-glaucoma medications were observed in both the ECP group and Ahmed group after operation(P<0.05),and the ECP group showed a significantly lower IOP compared to the Ahmed group at the 6-months(P=0.014)and 12-months(P=0.047)postoperative time points,while there was no significant difference of medication number between the two groups except for 1-day after surgery.The BCVA showed no marked difference between the two groups preoperatively and postoperatively(P>0.05),while it was significantly improved in ECP group at 3-months(P=0.001),6-months(P=0.004),and 12-months(P=0.010)time points comparing with preoperative BCVA.The surgical success rates in ECP group were also slightly higher than Ahmed group.And the complications after operation showed no marked differences.Conclusions:The comprehensive treatment of PPV,endoscopic PRP,and ECP surgery for NVG patients after antiVEGF injection can control IOP effectively and be friendly to patients’BCVA without obvious serious complications throughout a 12-months follow-up period.