Abstract
Purpose: To evaluate the long-term retinal microvascular, neural, and choroidal changes in the patients with severe nonproliferative diabetic retinopathy (NPDR) and proliferative diabetic retinopathy (PDR) following panretinal photocoagulation (PRP).Methods: Forty-five eyes of 28 patients with treatment-naive severe NPDR and PDR were included and followed for 12 months after PRP. Microvascular and neural changes in the macular and peripapillary areas were assessed by using optical coherence tomography angiography. Subfoveal choroidal thickness (SFCT) was measured by using optical coherence tomography. A Linear mixed-effects model was used to highlight the differences for the variables after adjusting for sex, age, and axial length.Results: Compared to baseline, there were no statistical differences in the best corrected visual acuity (BCVA), macular and peripapillary vessel density (VD), and SFCT following PRP. Macular thickness significantly increased at 1 and 3–6 months after PRP (p < 0.05), while the peripapillary retinal nerve fiber layer (RNFL) and ganglion cell complex (GCC) thickness significantly increased at 1 month postoperatively (p < 0.01). Global loss volume and focal loss volume significantly decreased at the same time point (p < 0.05).Conclusion: The unchanged BCVA, VD, the thickness of RNFL and GCC, and SFCT during the 12-month follow-up period suggest that PRP may prevent the retinal neurovascular and choroidal damage.
Highlights
Diabetic retinopathy (DR) is one of the most common microvascular complications of diabetes and is the leading cause of visual impairment among the working-age population across the globe [1]
Since fundus fluorescein angiography (FFA) is a gold standard for the diagnosis and grading of DR, the neural and choroidal changes cannot be evaluated by FFA with two-dimensional images
We present a prospective, longitudinal, and observational study to investigate the retinal microvascular, neural, and choroidal changes up to 1 year after PRP in severe non-proliferative diabetic retinopathy (PDR) (NPDR) and PDR by using multimodal imaging
Summary
Diabetic retinopathy (DR) is one of the most common microvascular complications of diabetes and is the leading cause of visual impairment among the working-age population across the globe [1]. Changes in the retinal microvascular and neural structure due to diabetes are considered fundamental to the pathophysiology and progression of DR. To the best of our knowledge, the comprehensive retinal vascular and neural changes in the macular and peripapillary area and subfoveal choroidal thickness (SFCT) changes after PRP have not been reported
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