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Retinal laser parameters—the relationship between laser spot spacing and maximum burn number

Eye volume 37, pages 3511–3512 (2023)Cite this article

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Patients with proliferative diabetic retinopathy (PDR) are treated with pan-retinal photocoagulation (PRP) laser to induce new vessel regression and reduce the risk of vision loss. In the Early Treatment Diabetic Retinopathy Study (ETDRS), 1600 500 micron diameter, 100 ms burns were applied for full PRP [1]. Newer laser modalities use shorter laser pulse durations of 10–20 ms. Short-pulse burns shrink over time [2, 3] and consequently a larger number of burns is needed to achieve disease control, when compared to the larger ETDRS burns. Muqit et al. [4] showed a linear relationship between PDR severity and the number of short-pulse burns needed to stabilise the retinopathy. Planning of PRP should take into account this target total burn number to minimise the risk of under- or over-treatment.

Short-pulse laser is typically applied in a multispot, square grid pattern (2 × 2 up to 5 × 5 burns). Laser may also be applied in a triangular equidistant pattern. With burns applied in a grid pattern, there is a limit to how many grids (and therefore burns) can be applied to a fixed area (i.e. the area of the retina) before having to either overlap grids or shrink the size of each grid by reducing the spacing between burns. The spacing between burns in a grid determines burn density and hence the total number of burns that can be applied in a non-overlapping pattern.

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Fig. 1

References

  1. Techniques for scatter and local photocoagulation treatment of diabetic retinopathy: Early Treatment Diabetic Retinopathy Study Report no. 3. The Early Treatment Diabetic Retinopathy Study Research Group. Int Ophthalmol Clin. 1987;27:254–64.

  2. Muqit MM, Gray JC, Marcellino GR, Henson DB, Young LB, Patton N, et al. In vivo laser-tissue interactions and healing responses from 20- vs 100-millisecond pulse Pascal photocoagulation burns. Arch Ophthalmol. 2010;128:448–55.

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Authors and Affiliations

  1. Cwm Taf Morgannwg University Health Board, Llantrisant, UK

    Kevin Gallagher & Ahmed Al-Janabi

  2. St Thomas’ Hospital, London, UK

    Nigel Davies

Authors
  1. Kevin Gallagher
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  2. Ahmed Al-Janabi
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  3. Nigel Davies
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Contributions

KG conceived the presented idea. All authors contributed to development of the concept and calculations and approved the final paper.

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Correspondence to Kevin Gallagher.

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Gallagher, K., Al-Janabi, A. & Davies, N. Retinal laser parameters—the relationship between laser spot spacing and maximum burn number. Eye 37, 3511–3512 (2023). https://doi.org/10.1038/s41433-023-02531-x

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  • DOI: https://doi.org/10.1038/s41433-023-02531-x

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