Abstract
BackgroundTo describe the longitudinal changes in retinal neovascularization elsewhere (NVE) as observed on optical coherence tomography angiography (OCTA) in proliferative diabetic retinopathy (PDR) treated by panretinal photocoagulation (PRP).MethodsEach patient included in this prospective clinical study was newly diagnosed with PDR and NVE confirmed by both fundus fluorescein angiography (FFA) and OCTA. They received four sessions of PRP using a multiwavelength laser. Best-corrected visual acuity (BCVA) and OCTA images of the NVE were obtained before each PRP session and at 1 month, 3 months, and 6 months after the PRP treatment. Generalized estimating equations (GEE) was used to investigate the differences between the BCVA and NVE areas before and after PRP.ResultsThirty-two eyes of 32 patients with a mean age of 50.56 ± 7.05 years were included. We found a statistically significant reduction in the NVE area at all time points compared with the baseline except at 6 months (all P < 0.05). Further analysis demonstrated no statistically significant change in the NVE area between two adjacent timepoints except from baseline to post-1st PRP (P < 0.05). BCVA at 3 months showed a statistically significant improvement compared with baseline (P < 0.05), but no significant changes in BCVA were observed during the other visits.ConclusionsWe found an overall regression in the NVE area following PRP starting as early as 1 week after the 1st session and lasting up to 3 months. OCTA provides quantitative information on vascular changes and could be a practical method for the longitudinal evaluation of neovascularization.
Highlights
To describe the longitudinal changes in retinal neovascularization elsewhere (NVE) as observed on optical coherence tomography angiography (OCTA) in proliferative diabetic retinopathy (PDR) treated by panretinal photocoagulation (PRP)
Anti-VEGF agents have demonstrated a positive effect in regressing retinal neovascularization in recent years, PRP is still recommended by 98% of retina specialists as the primary management of PDR [3]
The change in the NVE area was statistically significant from baseline to post-1st PRP (P = 0.0004; Table 1)
Summary
To describe the longitudinal changes in retinal neovascularization elsewhere (NVE) as observed on optical coherence tomography angiography (OCTA) in proliferative diabetic retinopathy (PDR) treated by panretinal photocoagulation (PRP). Proliferative diabetic retinopathy (PDR), characterized by retinal neovascularization at the disc (NVD) or elsewhere in the retina (NVE), is the most common form [2]. Anti-VEGF agents have demonstrated a positive effect in regressing retinal neovascularization in recent years, PRP is still recommended by 98% of retina specialists as the primary management of PDR [3]. In China, treatment with repeated injections of anti-VEGF agents is impractical in many patients because they are not covered by medical insurance, but the cost-effectiveness and relatively long duration of efficacy make PRP a sound and sensible choice for these patients
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