Efficacy comparison of multipoint and single point scanning panretinal laser photocoagulation in non-proliferative diabetic retinopathy treatment

doi:10.4239/wjd.v15.i8.1734

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World Journal of Diabetes

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1948-9358

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Baishideng Publishing Group Inc, 7041 Koll Center Parkway, Suite 160, Pleasanton, CA 94566, USA

Randomized Controlled Trial

World J Diabetes. Aug 15, 2024; 15(8): 1734-1741
Published online Aug 15, 2024. doi: 10.4239/wjd.v15.i8.1734

Efficacy comparison of multipoint and single point scanning panretinal laser photocoagulation in non-proliferative diabetic retinopathy treatment

Hui-Ling Yang, Ji-Pu Bu, Juan Yang, Hua Gong, Yang-Zhou Zhang

Yang-Zhou Zhang, Institute of Molecular Precision Medicine and Hunan Key Laboratory of Molecular Precision Medicine, Xiangya Hospital, Central South University,Changsha 410008, Hunan Province, China

Hua Gong, Juan Yang, Department of Ophthalmology, Xingsheng Hospital, Yiyang 413200, Hunan Province, China

Ji-Pu Bu, Department of Ophthalmology, Boshi Eye Hospital, Liuyang 410300, Hunan Province, China

Hui-Ling Yang, Department of Ophthalmology, Hunan Children‘s Hospital, Changsha 410007, Hunan Province, China

Author contributions: Zhang YZ, Gong H, Yang J, Bu JP, and Yang HL designed the research study; Zhang YZ, Gong H, and Bu JP performed the research; Zhang YZ, Gong H, and Yang J contributed new reagents and analytic tools; Zhang YZ, Bu JP, and Yang HL analyzed the data and wrote the manuscript; All authors have read and approved the final manuscript.

Institutional review board statement: This study was reviewed and approved by the Ethics Committee of Xiangya Hospital Central South University.

Clinical trial registration statement: This study has not yet been registered with clinical trials.

Informed consent statement: All research participants or their legal guardians provided written informed consent prior to study registration.

Conflict-of-interest statement: No conflict of interest is associated with this work.

Data sharing statement: No other data are available.

CONSORT 2010 statement: The authors have read the CONSORT 2010 Statement, and the manuscript was prepared and revised according to the CONSORT 2010 Statement.

Corresponding author: Hui-Ling Yang, MBBS, Doctor, Department of Ophthalmology, Hunan Children‘s Hospital, No. 86 Ziyuan Road, Changsha 410007, Hunan Province, China. yanghl1211@126.com

Received: April 8, 2024
Revised: May 28, 2024
Accepted: June 27, 2024
Published online: August 15, 2024
Processing time: 108 Days and 17 Hours

Abstract

BACKGROUND

Non-proliferative diabetic retinopathy (NPDR) poses a significant challenge in diabetes management due to its microvascular changes in the retina. Laser photocoagulation, a conventional therapy, aims to mitigate the risk of progressing to proliferative diabetic retinopathy (PDR).

AIM

To compare the efficacy and safety of multi-spot vs single-spot scanning panretinal laser photocoagulation in NPDR patients.

METHODS

Forty-nine NPDR patients (86 eyes) treated between September 2020 and July 2022 were included. They were randomly allocated into single-spot (n = 23, 40 eyes) and multi-spot (n = 26, 46 eyes) groups. Treatment outcomes, including best-corrected visual acuity (BCVA), central macular thickness (CMT), and mean threshold sensitivity, were assessed at predetermined intervals over 12 months. Adverse reactions were also recorded.

RESULTS

Energy levels did not significantly differ between groups (P > 0.05), but the multi-spot group exhibited lower energy density (P < 0.05). BCVA and CMT improvements were noted in the multi-spot group at one-month post-treatment (P < 0.05). Adverse reaction incidence was similar between groups (P > 0.05).

CONCLUSION

While energy intensity and safety were comparable between modalities, multi-spot scanning demonstrated lower energy density and showed superior short-term improvements in BCVA and CMT for NPDR patients, with reduced laser-induced damage.

Keywords: Panretinal laser photocoagulation; Non-proliferative diabetic retinopathy; Efficacy comparison; Multipoint; Single point; Treatment assessment

Core Tip: This study compares the therapeutic effectiveness of multipoint and single-point scanning panretinal laser photocoagulation in non-proliferative diabetic retinopathy (NPDR) patients. The results showed that both treatment modalities had similar energy intensity and safety profiles, but the multipoint scanning mode had a lower energy density. In the short term, the multipoint scanning mode demonstrated better improvement in best-corrected visual acuity and central macular thickness compared to the single-point mode. Additionally, the multipoint mode resulted in less laser damage. These findings suggest that multipoint scanning may be a preferred treatment approach for NPDR patients.