The effect of panretinal photocoagulation on confocal laser scanning ophthalmoscopy and stereo photographic parameters of optic disk topography in patients with diabetic retinopathy.

Breno Marques da Silva Azevedo,Marina R. Ciongoli,Mario Luiz Ribeiro Monteiro,Rony Carlos Preti,Rafael Barbosa de Araujo,Leandro Cabral Zacharias,Marcelo Hatanaka

doi:10.5935/0004-2749.20190060

Abstract

To determine the effect of panretinal photocoagulation on optic disk topographic parameters in non-glaucomatous patients with proliferative diabetic retinopathy. This was a prospective, single-center, observational study. Thirty-eight eyes of 26 patients with diabetes underwent panretinal photocoagulation for proliferative diabetic retinopathy. Stereoscopic disk photographs and optic nerve head parameters were evaluated using the Zeiss fundus camera and the confocal scanning laser ophthalmoscope (Heidelberg Retinal Tomograph), respectively, at baseline and 12 months after the completion of panretinal photocoagulation. Thirty-eight eyes of 26 patients (15 female) with a mean age of 53.7 (range 26-74) years were recruited. No significant difference was found between the stereo photography determined mean horizontal and vertical cup-to-disk ratio before and after panretinal photocoagulation treatment (p=0.461 and 0.839, respectively). The global values of the optic nerve head parameters analyzed with the HRT3 showed no significant change from baseline to 12 months, including the disk area, cup area, rim area, cup volume, rim volume, cup-to-disk area ratio, linear cup-to-disk ratio, mean cup depth, maximum cup depth, cup shape measure, height variation contour, mean retinal nerve fiber layer thickness, and cross-sectional area. Our results suggest that panretinal photocoagulation does not cause morphological optic disk changes in patients with diabetic proliferative retinopathy after 1 year of follow-up.

Highlights

Diabetic retinopathy (DR) is the most common ocular complication of diabetes mellitus (DM) and is one of the leading causes of blindness in developed countries[1]
Our results suggest that panretinal photocoagulation does not cause morphological optic disk changes in patients with diabetic proliferative retinopathy after 1 year of follow-up
panretinal photocoagulation (PRP) reduces the risk of severe vision loss[2], it laser energy has been shown to cause destruc tion to all layers of the retina, including the ganglion cells and the retinal nerve fiber layer (RNFL), and generate visual field defects similar to those observed in glaucomatous damage[3]

Summary

Introduction

Diabetic retinopathy (DR) is the most common ocular complication of diabetes mellitus (DM) and is one of the leading causes of blindness in developed countries[1]. PRP reduces the risk of severe vision loss[2], it laser energy has been shown to cause destruc tion to all layers of the retina, including the ganglion cells and the retinal nerve fiber layer (RNFL), and generate visual field defects similar to those observed in glaucomatous damage[3]. In such cases, visual field testing can be less helpful to evaluate glaucomatous damage in patients with PDR treated with PRP. Evaluating the optic disk cupping and possible glaucomatous damage in patients with DR can be difficult, especially after PRP treatment

Objectives

Methods

Results

Conclusion