Abstract
Objectives: We aimed to investigate the short-term changes in macular choroidal thickness and volume after Panretinal Photocoagulation (PRP) in patients with Proliferative Diabetic Retinopathy (PDR) using a choroidal thickness map with Spectral-Domain Optical Coherence Tomography (SD-OCT). Methods: In this retrospective study, we reviewed the charts of patients who received PRP for diabetic retinopathy. Central volume scans using a 25-scan pattern and macular thickness map protocols were subsequently performed using the Spectralis OCT before and 1 month after PRP. Retinal thickness was measured by automated segmentation and choroidal thickness was obtained using a volume scan program with manual segmentation. For segmentation of the choroidal layer, the reference lines of the retinal boundary were adjusted to the choroidal boundary. Macular thickness maps were divided into nine sectors according to the ETDRS layout and analyzed to evaluate changes in macular thickness and volume. Results: In all, 49 patients (49 eyes) with early PDR were included. The mean central retinal thickness and mean total retinal volume of all ETDRS subfields increased 1 month post-PRP (308.06 ± 50.75 μm, 9.72 mm3) compared with before PRP (279.84 ± 26.62 μm, 9.19 mm3; P 0.05). Conclusion: In the macular region, retinal thickness increased and choroidal thickness did not change 1 month after PRP. These results indicate that PRP may have little or no effect on the change in macular choroidal thickness or volume in patients with early PDR, although whether PRP causes a significant change in choroidal blood flow in the macular region is unclear.
Highlights
Panretinal Photocoagulation (PRP) has been approved as an effective treatment for stopping retinal neovascularization in patients with severe diabetic retinopathy [1,2,3]
Many previous studies have focused on the effects of PRP on changes in retinal thickness or retinal blood flow, far less attention has been paid to the effects of PRP on the choroid [14,15,16,17]
We reviewed the medical records of patients who received PRP for diabetic retinopathy at the Seoul National University Bundang Hospital
Summary
Panretinal Photocoagulation (PRP) has been approved as an effective treatment for stopping retinal neovascularization in patients with severe diabetic retinopathy [1,2,3]. This treatment constitutes performing multiple laser photocoagulation sessions on the peripheral retina with the purpose of destroying photoreceptor and retinal pigment epithelium cells under the treated retina. It has been presumed that post-laser release of inflammatory factors, accumulation of leukocytes in the non-photocoagulated retina, up-regulation of angiogenic growth factors, and increased retinal blood flow in the macula may be possible pathogenetic mechanisms responsible for the development of macular edema following PRP, the exact mechanism is poorly understood and remains unclear [7,10,11,12,13]. To our knowledge, there has been no study investigating topographic changes of the macular choroid before and after PRP
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