Macular Thickness Variation after Conventional and Short-Pulse Laser Treatment in Diabetic Patient by Optical Coherence Tomography
Author(s): Golam Faruk Hossain, Joly Yeasmin, Tariq Reza Ali, Tajmeh Mehtaj.
Background: Diabetic retinopathy is a leading cause of blindness, and this study evaluates the comparative impact of conventional and short pulse laser photocoagulation on macular thickness in PDR patients to optimize treatment outcomes. Aim: The aim of this study was to evaluate changes in macular thickness in patients with PDR treated with conventional single-spot laser photocoagulation versus short pulse laser photocoagulation, using Optical Coherence Tomography (OCT) measurements at baseline, 1 week, and 4 weeks post-treatment. Methodology: This prospective longitudinal study was conducted at Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka from July 2023-June 2024, total 22 PDR patients was selected by using consecutive sampling (11 eyes per group). Group I underwent single-spot laser photocoagulation in one session, and Group II received short pulse laser photocoagulation in two sessions. Inclusion criteria included PDR without macular edema (central thickness <300 \u00b5m) and diabetes mellitus, while exclusion criteria ruled out significant ocular comorbidities. Macular thickness was assessed using OCT before treatment and at 1- and 4-weeks post-treatment. All procedures were standardized, performed by a single surgeon, and data were analyzed with Statistical Package for the Social Sciences (SPSS) version 26. Result: The results showed significant increases in macular thickness in both groups, with the conventional laser group demonstrating a rise from 234.45 ± 44.91 μm pre-laser to 431.45 ± 104.12 μm at 4 weeks, and the short pulse laser group increasing from 241 ± 39.68 μm to 317.82 ± 94.82 μm. Statistically significant changes were observed at both 1-week and 4-week time points in both groups p=0.001. The study also highlighted differences in laser parameters, with the short pulse laser group using higher power, shorter pulse duration, and more spots compared to the conventional laser group. Both treatments demonstrated effectiveness in altering macular structure, with short pulse laser showing greater precision and efficiency. Conclusion: Both conventional and short pulse laser photocoagulation significantly increased macular thickness, with the short pulse laser showing greater efficacy. These results suggest that short pulse laser may offer a more efficient treatment for PDR.