None listed
Conditions
Brief summary
Long pulse duration pan retinal photocoagulation has been demonstrated the retinal structure damaged and extensive scar after treatment. The treatment should divided into two sessions to reduce the risk of macular edema. With the new concept of shorter pulse duration for panretinal photocoagulation, the expectency of less tissue damage and less chance of macular edema developed after treatment. The laser session may reduce into one session.
Interventions
Arm 1: multispots pattern panretinal photocoagulation using 400 micrometer spot size Arm 2: multispots pattern panretinal photocoagulation using 600 micrometer spot size Laser photocoagulation is performed using pattern scan system (Valon pattern laser, Dual laser LTD OY, Vantaa, Finland), which is a Nd-YAG 532 nm laser beam. The parameters are: 1) spot sizes of 200 or 300 micrometer with superquad 160 contact lens (laser spot magnification of 2.0; Volk Optical Inc., Mentor, OH) which equivalent to the retinal lesion size of 400 and 600 micrometer, respectively, 2) duration of 20 ms, 3) grid pattern of 4x4, 4) spot spacing of 1.5 widths apart, 5) intensity of gray-white burn, titrated at the major vascular area, 6) distribution extended from vascular arcade to beyond equator, no closer than 2 disc diameter temporal to fovea, no closer than 1 disc diameter to the nasal optic disc. All treatments are performed under topical anesthesia. Duration of the procedures are approximately 4 to 6 minutes. The re-treatment will be considered at 3 months and 6 months of follow-up. The indications of retreatment are persistence or recurrence of the neovascularization.
Sponsors
Study design
Eligibility
Inclusion criteria
severe diabetic retinopathy without macular edema (macular thickness of less than 350 micrometers by SD-OCT)
Exclusion criteria
Previous intraocular surgery macular thickness before treatment more than 350 micrometers by SD-OCT Associated disease affecting visual acuity Hemoglobin A1c more than 15