Abstract
OBJECTIVES:To determine the effect of panretinal photocoagulation (PRP) on the peripapillary retinal nerve fiber layer (RNFL) in nonglaucomatous patients with proliferative diabetic retinopathy (PDR).METHODS:This is a prospective, single center, observational study. Thirty-eight eyes of 26 diabetic patients underwent PRP for proliferative diabetic retinopathy. Peripapillary RNFL thickness was measured using scanning laser polarimetry (SLP) with variable corneal compensation (GDx VCC; by Carl Zeiss Meditec, Dublin, CA) and spectral-domain optical coherence tomography (OCT) (Heidelberg Spectralis, Carlsbad, USA) at baseline and 12 months after PRP was performed.RESULTS:Thirty-eight eyes of 26 patients (15 female) with a mean age of 53.7 years (range 26 to 74 years) were recruited. No significant difference was found among all RNFL thickness parameters tested by GDx VCC software (p=0.952, 0.464 and 0.541 for temporal-superior-nasal-inferior-temporal (TSNIT) average, superior average, inferior average, respectively). The nerve fiber indicator (NFI) had a nonsignificant increase (p=0.354). The OCT results showed that the average RNFL thickness (360° measurement) decreased nonsignificantly from 97.2 mm to 96.0 mm at 1 year post-PRP (p=0.469). There was no significant difference when separately analyzing all the peripapillary sectors (nasal superior, temporal superior, temporal, temporal inferior, nasal inferior and nasal thickness).CONCLUSION:Our results suggest that PRP, as performed in our study, does not cause significant changes in peripapillary RNFL in diabetic PDR patients after one year of follow-up.
Highlights
Diabetic retinopathy (DR) is one of the most significant ocular complications related to diabetes mellitus (DM) and is one of the main causes of blindness [1]
No significant difference was found among all the retinal nerve fiber layer (RNFL) thickness parameters tested by GDx variable corneal compensator (VCC) software (p= 0.952, 0.464 and 0.541 for temporal-superior-nasal-inferiortemporal (TSNIT) average, superior average, inferior average, respectively)
Laser photocoagulation decreases the risk of blindness in proliferative diabetic retinopathy (PDR) patients, and despite the evidence of efficacy of antiangiogenic drugs, it is still considered the standard of care for the management of proliferative disease, according to The American Academy of Ophthalmology’s Preferred Practice Pattern for Diabetic Retinopathy [20], which valorizes the findings of the Diabetic Retinopathy Study [2] and the Early Treatment Diabetic Retinopathy Research Study (ETDRS) [21]
Summary
Diabetic retinopathy (DR) is one of the most significant ocular complications related to diabetes mellitus (DM) and is one of the main causes of blindness [1]. DM is an important risk factor for chronic open angle glaucoma, and both diseases often coexist. In cases of proliferative diabetic retinopathy (PDR), panretinal photocoagulation (PRP) is still considered the firstline treatment. PRP reduces the risk of severe vision loss [2], it has been shown that laser energy can cause. Received for publication on February 5, 2019. Accepted for publication on September 24, 2019
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