Abstract
BackgroundDuring panretinal photocoagulation (PRP), the outer retina, especially the photoreceptors, are destroyed. During such procedures, the impact of the retinal photocoagulation, which is performed in the same photocoagulated area, may change if it is applied to different locations with different photoreceptor densities. Thus, we aimed to evaluate the influence of photoreceptor density on PRP.MethodsWe constructed a three-dimensional (3D) average distribution of photoreceptors with 3D computer-aided design (CAD) software using previously derived photoreceptor density data and calculated the number of photoreceptors destroyed by scatter PRP and full-scatter PRP (size 400-μm on the retina, spacing 1.0 spot) using a geometry-based simulation. To investigate the impact of photoreceptor density on PRP, we calculated the ratio of the number of photoreceptors destroyed to the total number of photoreceptors, termed the photoreceptor destruction index.ResultsIn this 3D simulation, the total number of photoreceptors was 96,571,900. The total number of photoreceptors destroyed by scatter PRP and full-scatter PRP were 15,608,200 and 19,120,600, respectively, and the respective photoreceptor destruction indexes were 16.2 and 19.8%, respectively.ConclusionsScatter PRP is expected to have 4/5 of the number of photoreceptors destroyed by full-scatter PRP.
Highlights
During panretinal photocoagulation (PRP), the outer retina, especially the photoreceptors, are destroyed
The numbers of spots derived from scatter PRP and full-scatter PRP were 1261 and 1837, respectively (Fig. 4a) [20]
The total numbers of photoreceptors destroyed by scatter PRP and full-scatter PRP were 15,608,200 and 19,120, 600, respectively
Summary
During panretinal photocoagulation (PRP), the outer retina, especially the photoreceptors, are destroyed. Severe retinal ischemic diseases include proliferative diabetic retinopathy (PDR) and central retinal vein occlusion (CRVO). PDR is caused by the progression of diabetic retinopathy, a microvascular complication of Severe ischemia causes dysfunction and destruction of photoreceptors and the production of cytokines [5], such as vascular endothelial growth factor (VEGF) [6]. These conditions cause leakage in the retinal vessels and neovascularization, leading to proliferative retinopathy. It has been postulated that the effects of the destruction of photoreceptors may be related to the fact that they require large quantities of oxygen and produce large amounts of VEGF during ischemic conditions [6]
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