Medium Duration Threshold Patterned Laser Photo coagulation for Panretinal Photocoagulation
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Submitted
October 22, 2015
Published
October 24, 2015
Abstract
Background: Laser photocoagulation is a crucial therapy for numerous retinal diseases. Laser can be delivered with different machines and modalities (slit lamp, endolaser, indirect laser) at different wavelengths (532 to 812 nm) with varying parameters (power, spot size, duration, number of spots). New developments using semi automatic pattern delivery of retinal laser burns which use smaller amounts of energy and shorter duration have been reported. This literature review is conducted to review various published article that reported efficacy, safety, and duration of medium duration threshold patterned (MDTP) laser photocoagulation.
Methods: This literature review was conducted from the Pubmed (NLM) database and Ophsource using the keyword panretinal photocoagulation, and Pascal or medium threshold or short exposure. The inculsion criteria of this review were all of studies which reported the use of medium duration threshold patterned which was applied as panretinal photocoagulation (PRP).
Results: Parameter used in MDTP laser were as follow, spot size was between 200 to 400 μm, duration was 20-30 ms, and average laser power was more than 200 to 630 mV. Compare to standard laser treatment, power used in MDTP laser were higher.
Conclusion: Medium duration threshold patterned laser photo-coagulation is as effective as conventional laser. MDTP laser can preserve the retinal sensitivity/visual field, also offers less pain and discomfort and safe to perform full scatter PRP in single sitting
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Keywords: medium duration threshold patterned laser; panretinal photocoagulation
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References
Lock JH, Fong KCS. Retinal laser photocoagulation. Med J Malaysia 2010;65:88-94
Staff AAO. Retina and Vitreous. Basic and clinical science course 12. San Fransisco: American Academy of Ophthalmology;2009-2010. p337-348
The Early Treatment Diabetic Retinopathy Study Research Group. Techniques for scatter and local photocoagulation treatment of diabetic retinopathy. Early treatment diabetic retinopathy study report no. 3. Int Ophthalmol Clin 1987;27:254—264
The Early Treatment Diabetic Retinopathy Study Research Group. Treatment techniques and clinical guidelines for photocoagulation of diabetic macular edema. Early treatment diabetic retinopathy study report number 2. Ophthalmology 1987;94:761-774
Blumenkranz MS, Yellachich D, Andersen DA et al. Semiautomated patterned scanning laser for retinal photocoagulation. Retina 2006;26:370e6
Modi D, Chiranand P, Akduman L. Efficacy of patterned scan laser in treatment of macular edema and retinal neovascularization. Clin Ophthalmol 2009;3:465—470
Sangvhi C, McLauchlan R, Delgado C, Young L, Charles SJ, Marcellino G, Stanga PE. Initial experience with the Pascal photocoagulator: a pilot study of 75 procedures. Br J Ophthalmol 2008;92:1061-1064
Diabetic Retinopathy Study Research Group. Photocoagulation treatment of proliferative diabetic retinopathy: clinical application of Diabetic Retinopathy Study (DSR) findings. Diabetic Retinopathy Study (DRS) Report number 8. Ophthalmology 1981;88:583—600
Fong DS, Girach A, Boney A. Visual side effects of successful scatter laser photocoagulation surgery for proliferative diabetic retinopathy: a literature review. Retina 2007;27:816e24
Muqit MMK, Marcellino GR, Henson DB, Young LB, Charles SJ, et al. SingleÂsession vs multipleÂsession scanning laser panretinal photocoagulation in proliferative diabetic retinopathy. Arch Ophthalmol 2010;128(5):525—533
Nagpal M, Marlecha S, Nagpal K. Comparison of laser photocoagulation for diabetic retinopathy using 532Ânm, standard laser versus pattern scan laser. Retina 2010;30:452- 458
Muqit MM, Gray JCB, Marcellino GR, Henson DB, Young LB, Charles SJ, et al. Fundus autofluorescence and Fourier- domain optical coherence tomography imaging of 10 and 20 millisecond Pascal retinal photocoagulation treatment. Br J Ophthalmol 2009;93:518—525
Rimmer T, Wykes W. Quicker painless diabetic laser. Eye 2007;21:140
Oxford Center for EvidenceÂBased Medicine – Levels of Evidence (March 2009). Available at http://www.cebm.net/ index.Aspx?o=1025
VelezÂMontoya R, GuerreroÂNaranjo JL, GonzalesÂMijares CC, FromowÂGuera J, Marcellino GR, QuirozÂMercado H, et al. Pattern scan laser photocoagulation: safety and complications, experience after 1301 consecutive cases. Br J Ophthalmol 2010;94:720-724
Muraly P, Limbad P, Srinivasan K, Ramasamy K. Single session of Pascal versus multiple sessions of conventional laser for panretinal photocoagulation in proliferative diabetic retinopathy: a comparative study. Retina 2011;31(7):1359-65
Muqit MMK, Marcellino GR, Gray JCB, McLauchlan R, Henson DB, Young LB, et al. pain responses of Pascal 20 ms multiÂspot and 100 ms singleÂspot panretinal photocoagulation: Manchester Pascal Study, MAPASS report 2. Br J Ophthalmol 2010;94:1493-1498
Muqit MMK, Marcellino GR, Henson DB, Fenerty CH, Stanga PE. Randomized clinical trial to evaluate the effects of Pascal panretinal photocoagulation on macular nerve fiber layer. Retina 2011;31(7):1359-65
Salman AG. Pascal layer versus conventional laser for treatment of diabetic retinopathy. Saudi J Ophthalmol 2011;25:175-179
AlÂHussainy S, Dodson PM, Gibson JM. Pain response and followÂup patients undergoing panretinal laser photocoagulation with reduced exposure times. Eye 2008;22:96-99
Chappelow AV, Tan K, Waheed NK, Kaiser PK. Panretinal photocoagulation for proliferative diabetic retinopathy: pattern scan laser versus argon laser. Am J Ophthalmol 2012;153:137-142
Muqit MMK, Sangvhi C, McLauchlan R, Delgado C, Young LB, Charles SJ, et al. Study of clinical application and safety fot Pascal laser photocagulation in retinal vascular disorder. Acta Ophthalmol 2010 (epub ahead of print)
L’esperance, Francis A. Diabetic retinopathy in ophthalmic lasers. Third edition. Volume 1. Mosby Company. USA 1989. P347Â424
Little HL, Zweng HC, Peabody RR. Argon laser slitÂlamp retinal photocoagulation. Trans Am Acad Ophthalmol Otolaryngol 1970;74(1):85-97
Jain A, Blumenkranz MS, Paulus Y, Wiltberger MW, Andersen DE, Huie P, Palanker D. Effect of pulse duration on size and character of the lesion in retinal photocoagulation. Arch Ophthalmol 2008;126(1):78-85
Bandello F, Brancato R, Menchini U, Virgili G, Lanzetta P, Ferrari E, Incorvaia C. Light panretinal photocoagulation (LPRP) versus classic panretinal photocoagulation (CPRP) in proliferative diabetic retinopathy. Semin Ophthalmol 2001;16:12-18
Muqit MMK, Gray JCB, Marcellino GR, Henson DB, Young LB, Patton N, et al. In vivo laser tissue interactions and healing response from 20Â vs 100Âmillisecond pulse Pascal photocoagulation burns. Arch Ophthalmol 2010;128(4):448-455
Palanker D, Lavinsky D, Blumenkranz MS, Marcellino G. The impact of pulse duration and burn grade on size of retinal photocoagulation lesion. Retina 2011;31:1664—1669
Paulus YM, Jain A, Gariano RF, et al. Healing of retinal photocoagulation lesions. Invest Ophthalmol Vis Sci 2008;49:5540-5545
Diabetic Retinopathy Clinical Research Network, Brucker AJ, Qin H, et al. Observational study of the development of diabetic macular edema following panretinal (scatter) photocoagulation Given in 1 or 4 sittings. Arch Ophthalmol 2009;127(2):132-140
Wade EC, Blankenship GW. The effect of short versus long exposure times of argon laser panretinal photocoagulation on proliferative diabetic retinopathy. Graefe’s Arch Clin Exp Ophthalmol 1990;228:226-231
Dowler JGF. Laser management of diabetic retinopathy. J R Soc Med 2003;96:277-279
Richardson C, Waterman H. Pain relief during panretinal photocoagulation for diabetic retinopathy: a national survey. Eye 2009;23(12):2233-7
Nalvira F, Elvioza, Sidik M, Bardosono S. Comparison of photocoagulation effect of medium threshold and conventional laser diabetic retinopathy. Unpublished.
Fok ACT, Luk FOJ, Wong VWY, Chan PPM, Lai TTY. Patient comfort levels and treatment parameters in laser photocoagulation: comparison of patterned scanning versus single spot laser machines. HKJ Ophthalmol 2011;15:68—70
Maeshima K, UtsugiÂSutoh N, Otani T, Kishi S. Progressive enlargement of scattered photocoagulation scars in diabetic retinopathy. Retina 2004;24(4):507-511
Pahor D. Visual field loss after argon laser panretinal photocoagulation in diabetic retinopathy: fullÂversus mild scatter coagulation. Int Ophthalmol 1998;22(5):507—511
Doft BH, Blankenship GW. Single versus multiple treatment session of argon laser panretinal photocoagulation for proliferative diabetic retinopathy. Ophthalmology 1982;89(7):772-779
Staff AAO. Retina and Vitreous. Basic and clinical science course 12. San Fransisco: American Academy of Ophthalmology;2009-2010. p337-348
The Early Treatment Diabetic Retinopathy Study Research Group. Techniques for scatter and local photocoagulation treatment of diabetic retinopathy. Early treatment diabetic retinopathy study report no. 3. Int Ophthalmol Clin 1987;27:254—264
The Early Treatment Diabetic Retinopathy Study Research Group. Treatment techniques and clinical guidelines for photocoagulation of diabetic macular edema. Early treatment diabetic retinopathy study report number 2. Ophthalmology 1987;94:761-774
Blumenkranz MS, Yellachich D, Andersen DA et al. Semiautomated patterned scanning laser for retinal photocoagulation. Retina 2006;26:370e6
Modi D, Chiranand P, Akduman L. Efficacy of patterned scan laser in treatment of macular edema and retinal neovascularization. Clin Ophthalmol 2009;3:465—470
Sangvhi C, McLauchlan R, Delgado C, Young L, Charles SJ, Marcellino G, Stanga PE. Initial experience with the Pascal photocoagulator: a pilot study of 75 procedures. Br J Ophthalmol 2008;92:1061-1064
Diabetic Retinopathy Study Research Group. Photocoagulation treatment of proliferative diabetic retinopathy: clinical application of Diabetic Retinopathy Study (DSR) findings. Diabetic Retinopathy Study (DRS) Report number 8. Ophthalmology 1981;88:583—600
Fong DS, Girach A, Boney A. Visual side effects of successful scatter laser photocoagulation surgery for proliferative diabetic retinopathy: a literature review. Retina 2007;27:816e24
Muqit MMK, Marcellino GR, Henson DB, Young LB, Charles SJ, et al. SingleÂsession vs multipleÂsession scanning laser panretinal photocoagulation in proliferative diabetic retinopathy. Arch Ophthalmol 2010;128(5):525—533
Nagpal M, Marlecha S, Nagpal K. Comparison of laser photocoagulation for diabetic retinopathy using 532Ânm, standard laser versus pattern scan laser. Retina 2010;30:452- 458
Muqit MM, Gray JCB, Marcellino GR, Henson DB, Young LB, Charles SJ, et al. Fundus autofluorescence and Fourier- domain optical coherence tomography imaging of 10 and 20 millisecond Pascal retinal photocoagulation treatment. Br J Ophthalmol 2009;93:518—525
Rimmer T, Wykes W. Quicker painless diabetic laser. Eye 2007;21:140
Oxford Center for EvidenceÂBased Medicine – Levels of Evidence (March 2009). Available at http://www.cebm.net/ index.Aspx?o=1025
VelezÂMontoya R, GuerreroÂNaranjo JL, GonzalesÂMijares CC, FromowÂGuera J, Marcellino GR, QuirozÂMercado H, et al. Pattern scan laser photocoagulation: safety and complications, experience after 1301 consecutive cases. Br J Ophthalmol 2010;94:720-724
Muraly P, Limbad P, Srinivasan K, Ramasamy K. Single session of Pascal versus multiple sessions of conventional laser for panretinal photocoagulation in proliferative diabetic retinopathy: a comparative study. Retina 2011;31(7):1359-65
Muqit MMK, Marcellino GR, Gray JCB, McLauchlan R, Henson DB, Young LB, et al. pain responses of Pascal 20 ms multiÂspot and 100 ms singleÂspot panretinal photocoagulation: Manchester Pascal Study, MAPASS report 2. Br J Ophthalmol 2010;94:1493-1498
Muqit MMK, Marcellino GR, Henson DB, Fenerty CH, Stanga PE. Randomized clinical trial to evaluate the effects of Pascal panretinal photocoagulation on macular nerve fiber layer. Retina 2011;31(7):1359-65
Salman AG. Pascal layer versus conventional laser for treatment of diabetic retinopathy. Saudi J Ophthalmol 2011;25:175-179
AlÂHussainy S, Dodson PM, Gibson JM. Pain response and followÂup patients undergoing panretinal laser photocoagulation with reduced exposure times. Eye 2008;22:96-99
Chappelow AV, Tan K, Waheed NK, Kaiser PK. Panretinal photocoagulation for proliferative diabetic retinopathy: pattern scan laser versus argon laser. Am J Ophthalmol 2012;153:137-142
Muqit MMK, Sangvhi C, McLauchlan R, Delgado C, Young LB, Charles SJ, et al. Study of clinical application and safety fot Pascal laser photocagulation in retinal vascular disorder. Acta Ophthalmol 2010 (epub ahead of print)
L’esperance, Francis A. Diabetic retinopathy in ophthalmic lasers. Third edition. Volume 1. Mosby Company. USA 1989. P347Â424
Little HL, Zweng HC, Peabody RR. Argon laser slitÂlamp retinal photocoagulation. Trans Am Acad Ophthalmol Otolaryngol 1970;74(1):85-97
Jain A, Blumenkranz MS, Paulus Y, Wiltberger MW, Andersen DE, Huie P, Palanker D. Effect of pulse duration on size and character of the lesion in retinal photocoagulation. Arch Ophthalmol 2008;126(1):78-85
Bandello F, Brancato R, Menchini U, Virgili G, Lanzetta P, Ferrari E, Incorvaia C. Light panretinal photocoagulation (LPRP) versus classic panretinal photocoagulation (CPRP) in proliferative diabetic retinopathy. Semin Ophthalmol 2001;16:12-18
Muqit MMK, Gray JCB, Marcellino GR, Henson DB, Young LB, Patton N, et al. In vivo laser tissue interactions and healing response from 20Â vs 100Âmillisecond pulse Pascal photocoagulation burns. Arch Ophthalmol 2010;128(4):448-455
Palanker D, Lavinsky D, Blumenkranz MS, Marcellino G. The impact of pulse duration and burn grade on size of retinal photocoagulation lesion. Retina 2011;31:1664—1669
Paulus YM, Jain A, Gariano RF, et al. Healing of retinal photocoagulation lesions. Invest Ophthalmol Vis Sci 2008;49:5540-5545
Diabetic Retinopathy Clinical Research Network, Brucker AJ, Qin H, et al. Observational study of the development of diabetic macular edema following panretinal (scatter) photocoagulation Given in 1 or 4 sittings. Arch Ophthalmol 2009;127(2):132-140
Wade EC, Blankenship GW. The effect of short versus long exposure times of argon laser panretinal photocoagulation on proliferative diabetic retinopathy. Graefe’s Arch Clin Exp Ophthalmol 1990;228:226-231
Dowler JGF. Laser management of diabetic retinopathy. J R Soc Med 2003;96:277-279
Richardson C, Waterman H. Pain relief during panretinal photocoagulation for diabetic retinopathy: a national survey. Eye 2009;23(12):2233-7
Nalvira F, Elvioza, Sidik M, Bardosono S. Comparison of photocoagulation effect of medium threshold and conventional laser diabetic retinopathy. Unpublished.
Fok ACT, Luk FOJ, Wong VWY, Chan PPM, Lai TTY. Patient comfort levels and treatment parameters in laser photocoagulation: comparison of patterned scanning versus single spot laser machines. HKJ Ophthalmol 2011;15:68—70
Maeshima K, UtsugiÂSutoh N, Otani T, Kishi S. Progressive enlargement of scattered photocoagulation scars in diabetic retinopathy. Retina 2004;24(4):507-511
Pahor D. Visual field loss after argon laser panretinal photocoagulation in diabetic retinopathy: fullÂversus mild scatter coagulation. Int Ophthalmol 1998;22(5):507—511
Doft BH, Blankenship GW. Single versus multiple treatment session of argon laser panretinal photocoagulation for proliferative diabetic retinopathy. Ophthalmology 1982;89(7):772-779
Authors
Habsyiyah, H., Elvioza, E., Victor, A. A., Djatikusumo, A., Andayani, G., & Yudantha, A. R. (2015). Medium Duration Threshold Patterned Laser Photo coagulation for Panretinal Photocoagulation. Ophthalmologica Indonesiana, 41(1). https://doi.org/10.35749/journal.v41i1.8
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Habsyiyah, H., Elvioza, E., Victor, A. A., Djatikusumo, A., Andayani, G., & Yudantha, A. R. (2015). Medium Duration Threshold Patterned Laser Photo coagulation for Panretinal Photocoagulation. Ophthalmologica Indonesiana, 41(1). https://doi.org/10.35749/journal.v41i1.8