Multispot for peripheral treatment

Panretinal photocoagulation (PRP) has remained the standard of care for advanced diabetic retinopathy (DR) since the late 1970s, when the Diabetic Retinopathy Study (DRS) and the Early Treatment Diabetic Retinopathy Study (ETDRS) [1, 2] reported their benefit in blindness prevention in the proliferative stages of the disease.

Conventional single spot PRP is inherently destructive, nevertheless in the past decade new technologies have been introduced resulting in the development of a new generation of laser systems: Multispot Lasers. These are able to produce individual laser pulses shorter by an order of magnitude (0.01s-0,02s). At the same time these impulses are directed in a quick sequence one after another in so-called patterns.

Multispot treatment on periphery

Treatment guidelines

Multispot laser photocoagulation is a novel method of delivering laser energy to the retina.

Before starting the laser treatment, the laser energy necessary for the production of one laser spot needs to be titrated (the pulse duration being shorter).

Thanks to a single spot, the laser energy is gradually increased until a grey laser spot is achieved.

The pattern can then be selected for treatment.

Multispot Treatment Guidelines

Clinical data

Characterized by the use of short pulse durations (10-20ms), the MultiSpot treatment mode offers many advantages over conventional photocoagulation in retinal treatments such as panretinal photocoagulation (PRP):

  • Less heat diffusion to the retina and choroid, less damage to the retinal nerve fiber layer1,2
  • Comfortable treatment better tolerated by patients3
  • Extremely fast treatment (full PRP in 1 session)4.

The MultiSpot treatment mode can be delivered through 4 customizable patterns for better adaptation to the treatment site: Square, Circle, Triple arcs, Single Spot.

Peripheral treatment - Clinical data PRP

Anti-VEGF vs Laser for PDR, a changing treatment paradigm?

30/09/2021
Dr Lihteh Wu talks about the controversies in laser treatment in 2021 during the EURETINA symposium.
Victor Chong
Dr Victor Chong
Physicians' operating place
London, United Kingdom
PRP remains the standard of care, especially in patients with PDR. A combination therapy of PRP and an anti-VEGF agent may be useful in treatment-naïve patients with PDR.
Renato Passos
Dr Renato Passos
Physicians' operating place
Universidade Federal de São Paulo, São Paulo
PRP remains the standard cost-effective treatment of choice for PDR, reducing the risk of severe visual loss over the long term by 50%. New laser techniques have recently emerged to decrease the side effects associated with PRP. Among these, the 577-nm multispot laser combines the benefits of yellow wavelength with the benefits of shorter pulse duration and automated patterns of delivery (predictable and adjustable burn spacing, less thermal diffusion to the choroid leading to less pain, and faster treatments, among others).
Victor Chong
Dr Victor Chong
Physicians' operating place
London, United Kingdom
PRP remains the standard of care, especially in patients with PDR. A combination therapy of PRP and an anti-VEGF agent may be useful in treatment-naïve patients with PDR.
Renato Passos
Dr Renato Passos
Physicians' operating place
Universidade Federal de São Paulo, São Paulo
PRP remains the standard cost-effective treatment of choice for PDR, reducing the risk of severe visual loss over the long term by 50%. New laser techniques have recently emerged to decrease the side effects associated with PRP. Among these, the 577-nm multispot laser combines the benefits of yellow wavelength with the benefits of shorter pulse duration and automated patterns of delivery (predictable and adjustable burn spacing, less thermal diffusion to the choroid leading to less pain, and faster treatments, among others).

Physicians

Talk about Multispot
Laser Therapy

Bibliography