Macular edema in four-versus-one session PRP with PASCAL in Diabetic retinopathy: The 4 to 1 trial

Session Details

Session Title: Free Paper Session 16: Vascular Diseases & Diabetic Retinopathy IV

Session Date/Time: Friday 08/09/2017 | 16:30-18:00

Paper Time: 17:42

Venue: Room 114

First Author: : P.Gabrielle FRANCE

Co Author(s): :    P. Massin   L. Kodjikian   C. Pallot   A. Soudry   A. Bron   C. Creuzot Garcher              

Abstract Details


To compare central retinal thickness (CRT) after panretinal photocoagulation (PRP) with a multi-spot semi-automated pattern-scanning laser (Pascal) in one session (1S-PRP) versus four monthly sessions (4S-PRP) in diabetic retinopathy.


We conducted a multi-centre (Dijon university Hospital, Paris Lariboisière Hospital and Lyon Croix-Rousse University Hospital), prospective, randomized and controlled non-inferiority trial evaluating Pascal PRP administered in a single-session versus four monthly sessions.


In this prospective multicentre study, patients with mild proliferative or severe non proliferative diabetic retinopathy (DR) were randomly assigned to 1S-PRP or 4S-PRP performed with a Pascal. Each patient underwent a complete ophthalmological examination including best corrected visual acuity (BCVA) measurement, 9-field retinophotography and Spectral-Domain Optical Coherence Tomography (SD-OCT) macular imaging during a 9 month-follow-up.


Eighty-one eyes of 81 patients with a mean age of 56.0 +/- 13.7 years were included. Variation of mean CRT was not statistically different between the two groups from baseline to 9 months (+17.5 +/- 26.5 m in 1S-PRP vs +21.0 +/- 27.7 m in 4S-PRP, p=0.5828). Variation of mean BCVA was not significantly different between the two groups from baseline to 9 months (-0.9 +/- 6.9 letters vs -0.5 +/- 6.6 letters, p=0.8150). The number of incomplete PRP and stabilisation of neovascularisation were not statistically different in both groups. No severe complication was recorded in both groups.


Our study showed the non-inferiority of PRP performed in one versus four monthly sessions with good safety and same clinical efficacy to treat mild proliferative or severe non proliferative diabetic retinopathy.

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