Comparison of the Effect of Pan-Retinal Photocoagulation and Intravitreal Conbercept Treatment on the Change of Retinal Vessel Density Monitored by Optical Coherence Tomography Angiography in Patients with Proliferative Diabetic Retinopathy.

Hongkun Zhao,Minzhong Yu,Cong Li,Chenjin Jin,Lin Lu,Lijun Zhou

doi:10.3390/jcm10194484

Abstract

Background: This study compares the changes in retinal vessel density (VD) after pan-retinal photocoagulation (PRP) and intravitreal conbercept (IVC) treatment in proliferative diabetic retinopathy (PDR) eyes by optical coherence tomography angiography (OCTA). Methods: A total of 55 treatment-naïve PDR eyes were included in this retrospective study. Of these, 29 eyes were divided into a PRP group, and 26 eyes were divided into an IVC group based on the treatment they received. OCTA was performed to measure macular and papillary VD at each follow-up in both groups. Results: The macular VD for superficial capillary plexus (SCP), deep capillary plexus (DCP), choriocapillaris (CC) and papillary VD for radial peripapillary capillary (RPC) between the two groups demonstrated no significant difference at baseline and month 12 (p > 0.05). The paired t-test results showed that the macular VD for SCP, DCP, CC and papillary VD for the RPC at month 12 did not differ to the baseline in each group (p > 0.05). Conclusions: During the 12-month follow-up, there was no significant change of macular and papillary VD between the PRP and IVC treatment in PDR eyes. Additionally, compared to the baseline, there were no significant changes of macular and papillary VD after either the PRP or IVC treatment. Considering the decrease in VD as DR progress, both treatment modalities can potentially prevent macular and papillary VD loss in PDR.

Highlights

The traditional treatment of proliferative diabetic retinopathy (PDR) is pan-retinal photocoagulation (PRP) established by the Early Treatment Diabetic Retinopathy Study (ETDRS) [1]
A total of 55 PDR eyes from 55 patients were included, in which 29 eyes were in the PRP group and 26 eyes were in the intravitreal conbercept (IVC) group
There was no significant difference between the two groups in terms of age, gender, glycated hemoglobin, duration of diabetes, best corrected visual acuity (BCVA) and central foveal thickness (CFT)

Summary

Introduction

The traditional treatment of proliferative diabetic retinopathy (PDR) is pan-retinal photocoagulation (PRP) established by the Early Treatment Diabetic Retinopathy Study (ETDRS) [1]. The effectiveness of PRP for preventing severe vision loss in PDR patients has been clinically proved for decades. Due to the retinal destruction caused by PRP, its side effects include loss of visual field, decrease in night vision and worsening diabetic macular edema (DME) [2]. A clinical trial PROTOCOL-S [3,4] found that intravitreal ranibizumab was noninferior to PRP for the management of PDR for up to 5 years. DME and less visual field loss compared to PRP cohorts [3,4]. PRP is no longer the obvious choice for the management of PDR

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