Lasers in Medical Science

, Volume 33, Issue 5, pp 1095–1102 | Cite as

Electroretinogram evaluation for the treatment of proliferative diabetic retinopathy by short-pulse pattern scanning laser panretinal photocoagulation

  • Haiyun Ye
  • Minzhong Yu
  • Lin Lu
  • Chenjin Jin
  • Guangwei Luo
Original Article


Panretinal photocoagulation (PRP) is a standard method for proliferative diabetic retinopathy (PDR) treatment. However, conventional PRP usually significantly damages the retinal structure and vision. Retinal pattern scanning laser (PASCAL) photocoagulation has emerged as a new technique with fewer complications for the treatment of retinal disorders. This study compares the therapeutic effects of short-pulse PASCAL to conventional single-spot PRP for PDR. Fifty-two PDR patients (104 eyes) were randomly assigned into a short-pulse PASCAL-PRP treatment (SP) group and a conventional PRP treatment (TP) group. The best corrected visual acuity (BCVA) and full-field flash electroretinogram (ERG) data were evaluated before and after the two treatments. The BCVA data between before and after the PRP treatments did not show any significant difference. After the PRP treatment, the b-wave amplitude (b-A) in the dark-adapted 3.0 ERG (p = 0.0005) and the amplitude in the light-adapted 3.0 flicker ERG (p = 0.009) were significantly higher in the SP group compared with that of the TP group. In addition, after the PRP treatment, the a-wave implicit time (a-T) of light-adapted 3.0 ERG prolonged significantly in the TP group compared to the SP group. Compared with the parameters before the treatments, the a-A and b-A under dark-adapted 3.0 ERG and the b-A under the light-adapted 3.0 ERG in both TP and SP groups after the treatments decreased significantly (p < 0.05). Short-pulse PASCAL-PRP significantly attenuated partial vision damage compared to conventional PRP, although it still caused limited retinal injury and mild reduction in retinal function. These findings suggest that short-pulse PASCAL-PRP is a promising technique for PDR treatment.


PASCAL PRP Electroretinogram Retinal function 


Funding information

This project was funded by Sun Yat-Sen University Clinical Research 5010 Project (2013007) and the Major Project of Guangzhou Science and Technology Committee (201707020008).

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and national research committee and with the 1964 Declaration of Helsinki and its later amendments or comparable ethical standards.

Informed consent

Informed consent was obtained from all individual participants included in the study.


  1. 1.
    Muqit MM, Marcellino GR, Henson DB, Young LB, Patton N, Charles SJ et al (2013) Optos-guided pattern scan laser (Pascal)-targeted retinal photocoagulation in proliferative diabetic retinopathy. Acta Ophthalmol 91:251–258. CrossRefPubMedGoogle Scholar
  2. 2.
    Jain A, Blumenkranz MS, Paulus Y, Wiltberger MW, Andersen DE, Huie P et al (2008) Effect of pulse duration on size and character of the lesion in retinal photocoagulation. Arch Ophthalmol 126:78–85CrossRefPubMedGoogle Scholar
  3. 3.
    Muqit MM, Gray JC, Marcellino GR, Henson DB, Young LB, Charles SJ et al (2009) Fundus autofluorescence and Fourier-domain optical coherence tomography imaging of 10 and 20 millisecond Pascal retinal photocoagulation treatment. Br J Ophthalmol 93:518–525CrossRefPubMedGoogle Scholar
  4. 4.
    Sanghvi C, McLauchlan R, Delgado C, Young L, Charles SJ, Marcellino G et al (2008) Initial experience with the Pascal photocoagulator: a pilot study of 75 procedures. Br J Ophthalmol 92:1061–1064CrossRefPubMedPubMedCentralGoogle Scholar
  5. 5.
    Nagpal M, Marlecha S, Nagpal K (2010) Comparison of laser photocoagulation for diabetic retinopathy using 532-nm standard laser versus multispot pattern scan laser. Retina 30:452–458CrossRefPubMedGoogle Scholar
  6. 6.
    Muqit MM, Marcellino GR, Henson DB, Young LB, Patton N, Charles SJ et al (2010) Single-session vs multiple-session pattern scanning laser panretinal photocoagulation in proliferative diabetic retinopathy: The Manchester Pascal Study. Arch Ophthalmol 128:525–533CrossRefPubMedGoogle Scholar
  7. 7.
    Paulus YM, Jain A, Nomoto H, Sramek C, Gariano RF, Andersen D et al (2011) Selective retinal therapy with microsecond exposures using a continuous line scanning laser. Retina 31:380–388CrossRefPubMedGoogle Scholar
  8. 8.
    Brucker AJ, Qin H, Antoszyk AN, Beck RW, Bressler NM, Browning DJ et al (2009) Observational study of the development of diabetic macular edema following panretinal (scatter) photocoagulation given in 1 or 4 sittings. Arch Ophthalmol 127:132–140CrossRefPubMedGoogle Scholar
  9. 9.
    Miller RF, Dowling JE (1970) Intracellular responses of the Müller (glial) cells of mudpuppy retina: their relation to b-wave of the electroretinogram. J Neurophysiol 33:323-341Google Scholar
  10. 10.
    Blumenkranz MS, Yellachich D, Andersen DE, Wiltberger MW, Mordaunt D, Marcellino GR et al (2006) Semiautomated patterned scanning laser for retinal photocoagulation. Retina 26:370–376CrossRefPubMedGoogle Scholar
  11. 11.
    Jain A, Collen J, Kaines A, Hubschman JP, Schwartz S (2010) Short-duration focal pattern grid macular photocoagulation for diabetic macular edema: four-month outcomes. Retina 30:1622–1626CrossRefPubMedGoogle Scholar
  12. 12.
    Tso MO, Wallow IH, Elgin S (1977) Experimental photocoagulation of the human retina. I. Correlation of physical, clinical, and pathologic data. Arch Ophthalmol 95:1035–1040CrossRefPubMedGoogle Scholar
  13. 13.
    McCulloch DL, Marmor MF, Brigell MG, Hamilton R, Holder GE, Tzekov R et al (2015) ISCEV standard for full-field clinical electroretinography (2015 update). Doc Ophthalmol 130:1–12. CrossRefPubMedGoogle Scholar
  14. 14.
    Sheth S, Lanzetta P, Veritti D, Zucchiatti I, Savorgnani C, Bandello F Experience with the Pascal(R) photocoagulator: an analysis of over 1,200 laser procedures with regard to parameter refinement. Indian J Ophthalmol 59:87–91Google Scholar
  15. 15.
    Perlman I, Gdal-On M, Miller B, Zonis S (1985) Retinal function of the diabetic retina after argon laser photocoagulation assessed electroretinographically. Br J Ophthalmol 69:240–246CrossRefPubMedPubMedCentralGoogle Scholar
  16. 16.
    Ben-Shlomo G, Belokopytov M, Rosner M, Dubinsky G, Belkin M, Epstein Y et al (2006) Functional deficits resulting from laser-induced damage in the rat retina. Lasers Surg Med 38:689–694CrossRefPubMedGoogle Scholar
  17. 17.
    Pinilla I, Lund RD, Sauve Y (2004) Contribution of rod and cone pathways to the dark-adapted electroretinogram (ERG) b-wave following retinal degeneration in RCS rats. Vis Res 44:2467–2474. CrossRefPubMedGoogle Scholar
  18. 18.
    Chappelow AV, Tan K, Waheed NK, Kaiser PK (2012) Panretinal photocoagulation for proliferative diabetic retinopathy: pattern scan laser versus argon laser. Am J Ophthalmol 153:137–142 e132CrossRefPubMedGoogle Scholar
  19. 19.
    Al-Hussainy S, Dodson PM, Gibson JM (2008) Pain response and follow-up of patients undergoing panretinal laser photocoagulation with reduced exposure times. Eye (Lond) 22:96–99CrossRefGoogle Scholar

Copyright information

© Springer-Verlag London Ltd., part of Springer Nature 2018

Authors and Affiliations

  1. 1.State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic CenterSun Yat-Sen UniversityGuangzhouChina
  2. 2.Department of Ophthalmology, Shanghai Children’s HospitalShanghai Jiao Tong UniversityShanghaiChina
  3. 3.Department of OphthalmologyUniversity Hospitals Cleveland Medical CenterClevelandUnited States

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