Optical Coherence Tomography Following Panretinal Photocoagulation Demonstrating Choroidal Detachment

Abstract

Retinal laser therapy such as panretinal photocoagulation can be associated with complications, including rare cases of choroidal detachment. This report describes high-resolution optical coherence tomography (OCT) imaging after retinal laser panretinal photocoagulation (PRP) in patients with proliferative diabetic retinopathy (PDR) demonstrating choroidal detachment. A series of three sequential patients with high-risk proliferative diabetic retinopathy who were PRP laser naïve were examined with spectral-domain OCT immediately after green solid-state laser or PASCAL® PRP treatment. All three patients demonstrated a significant choroidal detachment immediately after PRP treatment. By one month after PRP, the choroidal detachment resolved spontaneously in all patients. OCT examinations were performed to detect and evaluate the severity and the change of choroidal detachment and thickness measurements were quantified and demonstrated a mean decrease in choroidal thickness of 122 µm (p < 0.05 in all patients). Conventional green solid-state laser and PASCAL® laser both have the risk of developing complications such as choroidal detachment. While the rate of choroidal detachment has been reported to be quite low, this could be due to subclinical, self-limited, choroidal detachments. The risk could be larger than previously reported using modern high-resolution clinical optical imaging such as OCT.