Variability of thermal subthreshold retinal laser treatment plans.


Journal

Scientific reports
ISSN: 2045-2322
Titre abrégé: Sci Rep
Pays: England
ID NLM: 101563288

Informations de publication

Date de publication:
30 Sep 2024
Historique:
received: 19 05 2024
accepted: 20 09 2024
medline: 1 10 2024
pubmed: 1 10 2024
entrez: 30 9 2024
Statut: epublish

Résumé

To investigate the variability in subthreshold laser treatment plans for patients with diabetic macular edema or central serous chorioretinopathy. Diagnostic images from 20 patients were utilized, and 25 retina specialists generated subthreshold treatment plans along with a self-rated experience level. Evaluation comprised of i) Area Variability (AV): quantifies the consensus regarding the covered area and is the difference between the areas planned by 75% and 25% of the participants ii) mean Centroid Distance (CD): level of agreement on the localization of a treatment. Subgroup analysis investigated the impact of participants' experience levels, utilizing the Mann-Whitney-Wilcoxon test. The predominant plan style is a targeted treatment approach (92%) and avoidance of subfoveal region (89%). Mean CD is 71.0 ± 37.5 pixels (≈half disc diameter) and mean AV is 9.8%±8.9%. A slight difference is observed between the 50-75% areas, but a notable distinction exists between the 25-50% areas. Subgroup analysis revealed CD and AV value of 75.9 pixels and 24% in the lower experience level group as opposed to 55.9 pixels and 8.6% in the higher experience level group. There is significant variability in treatment planning which reduces with increased experience of retina specialists. While consensus is observed around focal points, differences in the surrounding extents persist.

Identifiants

pubmed: 39349668
doi: 10.1038/s41598-024-73763-4
pii: 10.1038/s41598-024-73763-4
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

22723

Investigateurs

Ulrike Rahn (U)
Christian-Dennis Rahn (CD)
Supriya Arora (S)
Jay Chhablani (J)
Eugene Ng (E)
Igor Kozak (I)
Claudio Iovino (C)
Dmitrii S Maltsev (DS)
Emad Abu Ishkheidem (EA)
Francesca Amoroso (F)
Francesca Amoroso (F)
Ignacio Ares (I)
Caroline Bormann (C)
Luis Cordovés Dorta (LC)
Per Heuvels (P)
Yoko Miura (Y)
Javier Montero Hernandez (JM)
Giuseppe Querques (G)
Alejandro Rius Filloy (AR)
José Antonio Roca Fernandez (JAR)
Jose Fernandez Vigo (JF)
Martin Ziegler (M)
Focke Ziemmssen (F)
Pradeep Prasad (P)

Informations de copyright

© 2024. The Author(s).

Références

National Eye Institute. Early photocoagulation for diabetic retinopathy. ETDRS report number 9. Early Treatment Diabetic Retinopathy Study Research Group. Ophthalmology. 98 (5 Suppl), 766–785 (1991).
van Dijk, H. W. et al. Variability in photocoagulation treatment of diabetic macular oedema. Acta Ophthalmol.91 (8), 722–727. https://doi.org/10.1111/j.1755-3768.2012.02524.x (2013).
doi: 10.1111/j.1755-3768.2012.02524.x pubmed: 22973860
Kozak, I. et al. Fluorescein angiography versus optical coherence tomography-guided planning for macular laser photocoagulation in diabetic macular edema. Retina (Philadelphia Pa). 34 (8), 1600 (2014).
doi: 10.1097/IAE.0000000000000120 pubmed: 24695064
Writing Committee for the Diabetic Retinopathy Clinical Research Network. Comparison of Modified-ETDRS and Mild Macular Grid Laser Photocoagulation Strategies for Diabetic Macular Edema. Arch. Ophthalmol.125 (4), 469–480. https://doi.org/10.1001/archopht.125.4.469 (2007).
doi: 10.1001/archopht.125.4.469
Tai, F. et al. Subthreshold Compared with Threshold Macular Photocoagulation for Diabetic Macular Edema: A Systematic Review and Meta-Analysis. Ophthalmology Retina. Published online Oct. https://doi.org/10.1016/j.oret.2023.09.022 (2023).
doi: 10.1016/j.oret.2023.09.022
Friberg, T. R. & Karatza, E. C. The treatment of macular disease using a micropulsed and continuous wave 810-nm diode laser. Ophthalmology. 104 (12), 2030–2038. https://doi.org/10.1016/s0161-6420(97)30061-x (1997).
doi: 10.1016/s0161-6420(97)30061-x pubmed: 9400762
Lavinsky, D. et al. SUBVISIBLE RETINAL LASER THERAPY: Titration Algorithm and tissue response. Retina. 34 (1), 87–97. https://doi.org/10.1097/IAE.0b013e3182993edc (2014).
doi: 10.1097/IAE.0b013e3182993edc pubmed: 23873164
Scholz, P., Altay, L. & Fauser, S. A review of Subthreshold Micropulse laser for treatment of Macular Disorders. Adv. Ther.34 (7), 1528–1555. https://doi.org/10.1007/s12325-017-0559-y (2017).
doi: 10.1007/s12325-017-0559-y pubmed: 28540655 pmcid: 5504253
Lavinsky, D. & Palanker, D. Nondamaging photothermal therapy for the retina: initial clinical experience with chronic central serous retinopathy. Retina. 35 (2), 213–222 (2015).
doi: 10.1097/IAE.0000000000000340 pubmed: 25158944
Wu, Z., Wang, H. & An, J. Comparison of the efficacy and safety of subthreshold micropulse laser with photodynamic therapy for the treatment of chronic central serous chorioretinopathy: a meta-analysis. Med. (Baltim).100 (17), e25722. https://doi.org/10.1097/MD.0000000000025722 (2021).
doi: 10.1097/MD.0000000000025722
Chhablani, J. et al. Comparison of different settings for yellow subthreshold laser treatment in diabetic macular edema. BMC Ophthalmol.18(1), https://doi.org/10.1186/s12886-018-0841-z (2018).
doi: 10.1186/s12886-018-0841-z pubmed: 29996798 pmcid: 6042372
Beniwal, A. et al. Comparison of two protocols of subthreshold micropulse yellow laser treatment for non-resolving central serous chorioretinopathy. Indian J. Ophthalmol.70 (9), 3341–3345. https://doi.org/10.4103/ijo.IJO_228_22 (2022).
doi: 10.4103/ijo.IJO_228_22 pubmed: 36018117 pmcid: 9675531
Donati, M. C. et al. Subthreshold yellow micropulse laser for treatment of diabetic macular edema: comparison between fixed and variable treatment regimen. Eur. J. Ophthalmol. Published Online April. 14, 1120672120915169. https://doi.org/10.1177/1120672120915169 (2020).
doi: 10.1177/1120672120915169
Keunen, J. E. E., Battaglia-Parodi, M., Vujosevic, S. & Luttrull, J. K. International Retinal Laser Society Guidelines for Subthreshold Laser Treatment. Trans. Vis. Sci. Tech.9 (9), 15. https://doi.org/10.1167/tvst.9.9.15 (2020).
doi: 10.1167/tvst.9.9.15
Chhablani, J. et al. SOLS (Subthreshold Laser Ophthalmic Society) writing committee, Subthreshold laser therapy guidelines for retinal diseases. Eye. Published online June 23, (2022). https://doi.org/10.1038/s41433-022-02136-w
Gimond, M. Chapter 11 Point Pattern Analysis | Intro to GIS and Spatial Analysis.; Accessed October 12, 2023. (2023). https://mgimond.github.io/Spatial/chp11_0.html
Matplotlib — Visualization with Python. Published 2023. Accessed October 12. (2023). https://matplotlib.org/
Starnawska, A., Schneider, U. & Hasler, P. Vergleich Der Laserbehandlung Mit Einem computergestützten Lasersystem durch einen erfahrenen versus einen unerfahrenen behandelnden Arzt. Klin. Monatsbl. Augenheilkd.229 (12), 1223–1226. https://doi.org/10.1055/s-0032-1327904 (2012).
doi: 10.1055/s-0032-1327904 pubmed: 23196811
Ober, M. D., Kernt, M., Cortes, M. A. & Kozak, I. Time required for navigated macular laser photocoagulation treatment with the Navilas
doi: 10.1007/s00417-012-2119-0
Lavinsky, D. et al. Randomized clinical trial evaluating mETDRS versus normal or high-density micropulse photocoagulation for diabetic macular edema. Invest. Ophthalmol. Vis. Sci.52 (7), 4314–4323. https://doi.org/10.1167/iovs.10-6828 (2011).
doi: 10.1167/iovs.10-6828 pubmed: 21345996
Alharif, E. M. A., Taha, H. N. E. & din, Rashed, M. A. Comparative study between subthreshold (micropulse) laser direct application to the edematous macula versus direct application to the peripheral healthy retina in the treatment of diabetic macular edema. Al-Azhar Int. Med. J. https://doi.org/10.58675/2682-339X.1800 (2023).
doi: 10.58675/2682-339X.1800
Považay, B., Brinkmann, R., Stoller, M. & Kessler, R. Selective Retina Therapy. In High Resolution Imaging in Microscopy and Ophthalmology (ed. Bille, J. F.) 237–259 (Springer International Publishing, 2019). https://doi.org/10.1007/978-3-030-16638-0_11 .
doi: 10.1007/978-3-030-16638-0_11
Chehade, L., Chidlow, G., Wood, J. & Casson, R. J. Short-pulse duration retinal lasers: a review. Clin. Exp. Ophthalmol.44 (8), 714–721. https://doi.org/10.1111/ceo.12754 (2016).
doi: 10.1111/ceo.12754 pubmed: 27059681

Auteurs

Ulrike Rahn (U)

UR Projects, Hamburg, Germany.

Christian-Dennis Rahn (CD)

UR Projects, Hamburg, Germany.

Supriya Arora (S)

Bahamas Vision Centre and Princess Margaret Hospital, Nassau, NP, Bahamas.

Eugene Ng (E)

Institute of Eye Surgery, UPMC Whitfield Hospital, Waterford, Ireland.

Igor Kozak (I)

Department of Ophthalmology, University of Arizona Tucson, Tucson, AZ, 85711, USA.

Jay Chhablani (J)

University of Pittsburgh, Pittsburgh, USA. jay.chhablani@gmail.com.
UPMC Eye Center, University of Pittsburgh, Pittsburgh, PA, USA. jay.chhablani@gmail.com.

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