Effect Of Panretinal Photocoagulation Research Articles

Effect of pan retinal photocoagulation on Macular and optic nerve capillary density and foveal avascular zone area in patients with diabetic retinopathy An OCT angiography study

Effect of pan retinal photocoagulation on Macular and optic nerve capillary density and foveal avascular zone area in patients with diabetic retinopathy An OCT angiography study

Regression of Neovascularization after Panretinal Photocoagulation Combined with Anti-VEGF Injection for Proliferative Diabetic Retinopathy-A Review.

Proliferative diabetic retinopathy (PDR) poses a significant therapeutic problem that often results in severe visual loss. Panretinal photocoagulation (PRP) has long been a mainstay treatment for this condition. Conversely, intravitreal anti-VEGF therapy has served as an alternative treatment for PDR. This review aimed to evaluate the effects of PRP combined with anti-VEGF therapy on the regression of neovascularization (NV), including functional outcomes and incidence of complications. The MEDLINE database was searched for articles evaluating regression of NV using a combination of the following terms: "proliferative diabetic retinopathy", "anti-VEGF", "panretinal photocoagulation", and "combined treatment". The search yielded a total of 22 articles. The analysis of their results indicated PRP combined with ant-VEGF therapy as superior over PRP alone in the management of PDR. Combination treatment yields better and faster regression of NV and a lower incidence of serious complications, such as vitreous hemorrhage and the need for pars plana vitrectomy. Nevertheless, complete regression of NV is not achieved in a significant proportion of patients. Further research is needed to establish the most effective schedule for intravitreal injections as an adjunct to PRP. The current literature shows that in some cases, cessation of anti-VEGF injection in combination treatment for PDR can lead to relapse of NV.

Effect of pan retinal photocoagulation on macular ganglion cell - inner plexiform layer and peripapillary retinal nerve fibre layer thickness

: To determine the effect of pan retinal photocoagulation (PRP) on spectral domain optical coherence tomography (SD OCT) morphologic parameters like macular ganglion cell-inner plexiform layer (GCIPL), peripapillary retinal nerve fibre layer (RNFL) thickness and central macular thickness (CMT) in diabetic retinopathy cases. This is a retrospective study including 52 eyes with severe non-proliferative to proliferative diabetic retinopathy without macular oedema who required PRP. Macular GCIPL, CMT and peripapillary RNFL thickness measured at baseline and at 1-, 6-, 12- and 18-months post PRP with SD OCT. CMT, Macular GCIPL and peripapillary RNFL thickness increased significantly at 1 month (p<0.05), thereafter a decreasing trend noted at 6, 12 and 18 months. At 18 month CMT, GCIPL and RNFL thickness are higher than baseline but not statistically significant except temporal RNFL and Average GCIPL (p<0.05). A significant correlation found between changes in temporal RNFL and average GCIPL thickness (Pearson Correlation coefficient r= 0.652, 0.557, 0.782, 0.624 at 1, 6, 12 and 18 months respectively. P<0.05 for all values) CMT, macular GCIPL and peripapillary RNFL thickness increase following PRP; peaking at month 1 and stabilizing through next 18 months. Macular GCIPL thickness could be a reproducible indicator of temporal RNFL.

RISK FACTORS FOR SURGERY OR BLINDNESS IN NEOVASCULAR GLAUCOMA EYES TREATED WITH ANTI-VEGF INJECTIONS BY A RETINA SPECIALIST.

To determine baseline patient characteristics that predict the need for glaucoma surgery or blindness in eyes with neovascular glaucoma (NVG) despite intravitreal antivascular endothelial growth factor therapy. This is a retrospective cohort study of patients with NVG who had not previously received glaucoma surgery and were treated with intravitreal antivascular endothelial growth factor injections at the time of diagnosis, from September 8, 2011, to May 8, 2020, at a large, retina subspecialty practice. Of 301 newly presenting NVG eyes, 31% required glaucoma surgery and 20% progressed to no light perception vision despite treatment. Patients with intraocular pressure >35 mmHg ( P < 0.001), two or more topical glaucoma medications ( P = 0.003), worse than 20/100 vision ( P = 0.024), proliferative diabetic retinopathy ( P = 0.001), eye pain or discomfort ( P = 0.010), and new patient status ( P = 0.015) at the time of NVG diagnosis were at a higher risk of glaucoma surgery or blindness regardless of antivascular endothelial growth factor therapy. The effect of panretinal photocoagulation was not statistically significant in a subgroup analysis of patients without media opacity ( P = 0.199). Several baseline characteristics at the time of presentation to a retina specialist with NVG seem to portend a higher risk of uncontrolled glaucoma despite the use of antivascular endothelial growth factor therapy. Prompt referral of these patients to a glaucoma specialist should be strongly considered.

Incidence and Sequelae of Macular Edema Post Pan-retinal Photocoagulation for Proliferative Diabetic Retinopathy

Purpose To study the incidence and sequelae of macular edema after Panretinal photocoagulation (PRP) for the treatment of proliferative diabetic retinopathy (PDR). Patients and Methods A prospective interventional clinical study included 42 eyes treated by PRP, for proliferative diabetic retinopathy over three sessions on three consecutive weeks. Baseline and 1-month postoperative data were collected including best-corrected visual acuity, detailed fundus examination and Spectral Domain Optical Coherence Tomography Macula (SD-OCT); to assess the Central Subfield Macular Thickness (CSMT) using the ETDRS Map. Results Forty-two eyes of 31 patients were included in the study with mean duration of diabetes of 16.9±5.7 years and mean HbA1c of 9.1±1.4. Mean pre-PRP vision was 0.44±0.2 log units, which improved to 0.41±0.2 log units (P=0.6). Mean pre-laser CSMT was 245.6±25.5 µm, which increased to 265.5±33.5 µm at 1-month follow-up after PRP (P=0.003). Four eyes (9.5%) had CSMT more than 300 µm with intraretinal edema. The mean change and percentage of change from baseline in CSMT between those patients and remaining patient were statistically insignificant (P=0.055 and 0.115 respectively). Changes in CSMT and changes in Log MAR BCVA at 4-week follow-up were inversely correlated. Conclusion Macular edema can be an unavoidable side effect of PRP especially in cases with baseline increased macular thickness. Vision is mostly not affected by PRP, however, changes in vision may be directly affected by macular thickness post-PRP.

Comparison of targeted retinal photocoagulation versus pan-retinal photocoagulation in the treatment of proliferative diabetic retinopathy

The aim of this study was to compare the efficacy of targeted retinal photocoagulation (TRP) with pan retinal photocoagulation (PRP) in the treatment of proliferative diabetic retinopathy (PDR). A total of 100 patients with PDR were enrolled in the study. The patients were divided into the TRP group (n=50) and the PRP group (n=50). The primary outcome measure was the proportion of patients who achieved a complete regression of PDR. Secondary outcome measures included the effect of TRP or PRP on visual acuity, visual fields and the need for further treatments. The results showed that the TRP is an effective treatment modality in proliferative retinopathy regression (86%) like PRP group (72%). The TRP group also showed a visual acuity improvement (0.19 logMAR) compared to the PRP group (mean improvement of 0.13 logMAR) with good preservation of visual fields. There were no significant differences in the need for further treatments between the two groups. These results suggest that TRP is safe treatment option for PDR. Material and Methods: This study was conducted in the Department of ophthalmology Khyber Teaching Hospital Peshawar from January 2020 to July 2021. A total of 100 patients with proliferative diabetic retinopathy were included in the study.

Effect of panretinal photocoagulation on retina and choroid in diabetic retinopathy: An optical coherence tomography angiography study

BackgroundTo analyze the quantitative changes in both macular, and choroidal thickness, and microvascularization after panretinal photocoagulation (PRP) in eyes with proliferative diabetic retinopathy (PDR) or severe non-proliferative diabetic retinopathy (NPDR) by using optical coherence tomography angiography (OCT-A). MethodsThe patients diagnosed with severe NPDR or PDR according to the Early Treatment Diabetic Retinopathy Study (ETDRS) and decided to be treated with PRP were included in this prospective and observational study. Ten eyes of 10 patients with PDR and twelve eyes of 12 patients with severe NPDR were examined. Macular scans (6 × 6 mm) were obtained from OCT-A at baseline and at month 6 after PRP. Subfoveal choroidal thickness (SFCT) measurements that were obtained through the foveolar center on a high-definition line scan were recorded. ResultsBest-corrected visual acuity (BCVA) significantly decreased (p = 0.018), central foveal thickness and mean parafoveal thickness significantly increased (p < 0001 and p < 0.001, respectively) six months after PRP. The thickness of all parafoveal retinal quadrants (temporal, superior, nasal, inferior) increased (p = 0.001, p = 0.003, p < 0.001, p < 0.001, respectively) and mean parafoveal, parafoveal temporal, and parafoveal nasal vessel density of the deep capillary plexus (DCP) significantly decreased six months after PRP compared with the baseline values (p = 0.023, p = 0.041, p = 0.018, respectively). ConclusionsThe parafoveal vessel density of DCP decreased significantly 6 months after PRP in eyes with PDR or severe NPDR. While the difference in SFCT and choroidal flow density was not significant from the baseline; central and parafoveal retinal thickness increased and BCVA decreased significantly 6 months after PRP treatment.

Macular vessel density before and after panretinal photocoagulation in patients with proliferative diabetic retinopathy

IntroductionDiabetic retinopathy (DR) is microangiopathy causing ischemia leading to proliferative diabetic retinopathy and macular edema. Panretinal photocoagulation (PRP) reverses the ischemia leading to regression of neovessels. Most previous studies showed the large vessel effects of PRP, while optical coherence tomography angiography (OCTA) allowed noninvasive quantification of microvascular retinal changes.AimTo study the effect of PRP on microvascular retinal vessels in a detailed manner at different retinal and choroidal levels using OCTA.Patients and methodsThis study was a prospective interventional study. 30 eyes of 18 diabetic patients with PDR were included. All patients were evaluated clinically and with OCTA (Avanti RTVue-XR system, Optovue) to evaluate superficial and deep vessels density (VDs), choroidal flow, and FAZ area before PRP (base line) and 1 month and 6 months after PRP.ResultsPRP improved vessels density at superficial (SCP), deep (DCP), and choriocapillaris levels. Foveal vessel density at SCP and DCP were statistically significantly increased. SCP was 28.76 ± 2.56 at base line and was increased to 29.84 ± 2.47 and 30.89 ± 2.20 after 1 month and after 6 months, respectively. DCP was 34.08 ± 5.59 at base line and was increased to 34.93 ± 5.66 and 36.09 ± 5.62 after 1 month and after 6 months, respectively. Foveal choriocapillaris was statistically significantly increased from 63.04 ± 2.66 at base line to 63.48 ± 2.65 and 63.98 ± 2.78 after 1 month and 6 months, respectively. Choroidal flow was increased from 1.74 ± 0.07 at base line to 1.75 ± 0.09 at 1 month which was nonsignificant (P = 0.72), but it was significantly increased to 1.87 ± 0.27 6 months after PRP (P = 0.009). FAZ area was significantly improved after PRP. FAZ area was decreased from 0.56 ± 0.27 at base line to 0.50 ± 0.21 after 1 month and to 0.46 ± 0.21 after 6 months.ConclusionOCTA parameters were significantly improved by PRP in PDR patients, possibly due to redistribution of blood in occluded capillary plexuses.Trials registry: NCT04976361.

The Effect of Panretinal Photocoagulation Treatment on Vision-Related Quality of Life of Patients with Proliferative Diabetic Retinopathy at Kariadi Hospital

Objectives: Proliferative Diabetic Retinopathy (PDR) is one of the leading causes of blindness and visual loss. Panretinal Photocoagulation (PRP) reduces the risk of severe vision loss in PDR. Good visual acuity results can improve vision-related quality of life. The objective of this study is to evaluate the effect of laser PRP on patients with PDR on vision-related quality of life. Methods: In this prospective study, 30 PDR patients (12 men and 18 women) treated with PRP were included (mean age: 51 years, SD: 5,08 years). On average, patients received 1.264 laser spots. The National Eye Institute 7-Item Visual Function Index (VF-7) was used to evaluate patient's vision-related quality of life. The VF-7 was filled in by interview twice, at the beginning before laser PRP and at least 1 month after the completion of PRP. Comparison of VF-7 before and after laser PRP was performed. The correlation between alteration in visual acuity and VF-7 will be evaluated. Results: Mean VF-7 before laser PRP was 7.00 ± 0.00 and after laser PRP it was 3.43 ± 3.16 (p&lt;0.001, Wilcoxon). VF-7 scores had a statistically significant difference between before and after laser PRP (p&lt;0.05). There was a strong correlation between VF-7 score alteration with visual acuity (p &lt;0.001, r 0.748). Conclusion: There was a significant improvement in vision-related quality of life following panretinal photocoagulation of patients with proliferative diabetic retinopathy.

Effects of Panretinal photocoagulation on the ocular surface and tear film

Effects of Panretinal photocoagulation on the ocular surface and tear film

Effect of 532nm argon laser pan retinal photocoagulation on corneal thickness and corneal endothelial cell parameters among proliferative diabetic retinopathy patients.

Laser photocoagulation has been the mainstay treatment for diabetic retinopathy (DR). However, the applied laser light must pass through multiple ocular structures such as the cornea to reach the retina, potentially causing thermal injury to non-target tissues. The purpose of this study was to examine the effects of 532nm Argon laser pan-retinal photocoagulation (PRP) on corneal thickness and corneal endothelial cell parameters by comparing central corneal thickness (CCT), endothelial cell density (ECD), and endothelial cell area coefficient of variation (CoV) before and after PRP for proliferative diabetic retinopathy (PDR). The effect of laser PRP on these corneal parameters may help in adapting treatment protocols to reduce corneal damage and thereby improve patient outcome. This was a prospective cohort study involving newly diagnosed PDR patients. All patients underwent specular microscopy examination (CCT, ECD and endothelial cell area CoV) both pre-PRP and at 1-week and 6-weeks after the final PRP session (post-PRP). A Carl Zeiss Visulas Argon laser (532nm) was used to perform PRP. A total of 33 newly diagnosed PDR patients were included in this study. There were no significant differences in mean CCT, ECD, and endothelial cell area CoV at 1-week and 6-weeks following PRP compared to pre-treatment baseline (p > 0.05). Further, there were no significant correlations between laser energy delivered and CCT, ECD and endothelial cell area CoV at either post-PRP examination time. Argon laser (523nm) energy delivered within recommended ranges for PRP had no adverse effects on corneal structure.

Changes in choroidal thickness in advanced diabetic retinopathy treated with pan-retinal photocoagulation using a pattern scanning laser versus a conventional laser

BackgroundTo compare the effect of pan-retinal photocoagulation (PRP) using pattern scanning or conventional laser on subfoveal choroidal thickness (SFChT).MethodsThirty-eight patients (64 eyes) with advanced diabetic retinopathy (DR) who underwent PRP using pattern scanning or conventional laser were included. Changes in SFChT were compared with baseline values at 1, 3, 6, and 12 months after PRP using swept-source optical coherence tomography.ResultsThe conventional laser group showed a statistically significant decrease in SFChT at 1, 3, 6, and 12 months after PRP (P < 0.001). SFChT was significantly decreased at 3 (P = 0.025), 6 (P = 0.004), and 12 (P < 0.001) months after treatment in the pattern laser group.ConclusionEyes with advanced DR showed a significant reduction in SFChT over 12 months regardless of the type of laser used; however, the reduction was sooner after conventional laser than after pattern laser.

Efficacy of conbercept combined with panretinal photocoagulation in the treatment of proliferative diabetic retinopathy

This prospective clinical study was to compare the effect of panretinal photocoagulation (PRP) associated with intravitreal conbercept injections versus PRP alone in the treatment of proliferative diabetic retinopathy (PDR). For each of 15 patients included, one eye was randomly assigned to receive treatment with PRP, and the other eye received conbercept combined PRP. Ophthalmic examinations, optical coherence tomography (OCT) and optical coherence tomography angiography (OCTA) were performed at baseline and at each monthly visit until 6 months. Fluorescein angiography (FA) was acquired at baseline, 3 months and 6 months. Between group and within group analysis was done by using generalized estimating equations (GEE). The combination group had a significant decrease of neovascularization (NV) leakage area than the PRP group at month 3 and month 6 after treatment, and a better best-corrected visual acuity (BCVA) during the first three months. Within-group analysis indicated a significant decrease in NV leakage at month 3 and month 6 in both groups, and a significant increase in BCVA at 1 month in the combination group. In summary, the combination of intravitreal injection of conbercept and PRP can significantly reduce the NV of PDR patients and achieve better BCVA during the drug’s lifespan compared with PRP alone.

A meta-analysis to study the effect of pan retinal photocoagulation on retinal nerve fiber layer thickness in diabetic retinopathy patients

Background. Diabetic retinopathy is a microvascular disease, it is associated with changes in peripapillary retinal nerve fiber layer thickness, these changes being more pronounced in PDR (Proliferative diabetic retinopathy) patients undergoing laser photocoagulation. Objective. To assess changes in peripapillary retinal nerve fiber layer thickness in proliferative diabetic retinopathy patients using optical coherence tomogram (OCT). Methods. The database search was conducted in June 2018 and continued until October 2018. The search engines used included Pubmed, Medline, OVID and Google Scholar. A meta-analysis of weighted mean difference and standard deviation was conducted. Results. A total of 10 studies containing 377 eyes of PDR patients were selected. The analysis of the included studies revealed no significant effect of PRP on average retinal nerve fiber layer thickness (0.249, 95% CI: -0.985 to 1.483) using OCT. Conclusion. Hence, to conclude, our meta-analysis revealed that there was no significant effect of PRP on RNFL thickness and the impact of PRP could vary. Measurement of peripapillary RNFL thickness may yield erroneous and unpredictable results in this subgroup of patients, further confounding the evaluation of nerve fiber layer damage and its progression.

Effect of panretinal photocoagulation on optic nerve head blood flow with OCT angiography in patients with diabetic retinopathy.

Objective:To investigate the effect of pan retinal photocoagulation (PRP) on Optic nerve head blood flow with OCT angiography in patients with proliferative diabetic retinopathy.Methods:This prospective interventional study was conducted at Eye Unit III, Institute of Ophthalmology, Mayo Hospital, Lahore, over a period of seven months i.e. from 10th May 2019 to 10th November 2019. Thirty-five patients having proliferative diabetic retinopathy were included in this study. Ocular blood flow was measured with OCT Angiography, then pan retinal photocoagulation was performed and patients were called for follow-up after one month and ocular blood flow was measured again with OCT Angiography. The difference in the blood flow was calculated. Frequencies and percentages were calculated for the categorical data and mean and standard deviations were calculated for the continuous data. Wilcoxon matched-pairs signed rank test was performed and effects of PRP on blood flow were compared. Significance level was taken as p≤0.05.Results:Out of 35 patients, 30 patients (85.71%) had decreased post PRP blood flow, four patients (11.43%) had increased post PRP blood flow and one patient (2.86%) did not have any effect.Conclusion:OCT angiography revealed there is significantly reduced optic nerve head blood flow in PRP treated eyes compared to non-PRP treated eyes.

Peripapillary retinal nerve fiber layer thickness changes after panretinal photocoagulation and its relation with visual acuity changes in patients with diabetic retinopathy

Background: Panretinal photocoagulation (PRP) is currently the main treatment for proliferative diabetic retinopathy. Optical coherence tomography (OCT) is a noninvasive method of analyzingin vivo retinal architecture. Objectives: The objective was to evaluate the effect of PRP on peripapillary retinal nerve fiber layer thickness (RNFLT) in patients with diabetic retinopathy using OCT and to correlate peripapillary RNFLT changes with the changes in visual acuity (VA). Materials and Methods: This is a prospective study including eighty eyes of eighty patients with proliferative diabetic retinopathy (PDR) and severe non-PDR. PRP was done with frequency-doubled Nd: YAG (532 nm) laser. Peripapillary RNFLT was measured by spectral-domain OCT at baseline and 6 months post-PRP and assessed using paired t-test. The baseline VA and changes in VA 6 months post PRP were recorded. The relationship between RNFL loss and changes in VA was assessed using ANOVA and independent t-test. Results: The mean age of the patients was 60 years, with 65% of males and 35% of females. At 6 months post-PRP, there was a significant reduction in average RNFLT with a reduction in all quadrants, except in the temporal quadrant. According to interval changes of VA, the patients were divided into improved (22.5%), unchanged (48.8%), or worsened (28.7%) groups. Improved VA group showed a significant decrease in peripapillary RNFLT. Conclusion: RNFLT reduction following PRP can be due to axonal loss secondary to the direct or indirect effects of PRP. The extremely mild reduction in the temporal quadrant can be due to the sparing of papillomacular bundle during laser treatment.

Effects of panretinal photocoagulation on retinal vasculature and foveal avascular zone in diabetic retinopathy using optical coherence tomography angiography: A pilot study

PurposeTo evaluate the optical coherence tomography angiography (OCTA) parameters in patients with diabetic retinopathy following panretinal photocoagulation (PRP). MethodsEleven eyes of 6 patients with very severe nonproliferative diabetic retinopathy (NPDR) or early proliferative diabetic retinopathy (PDR) were recruited in this prospective interventional pilot study. All patients underwent OCTA imaging at baseline, and choroidal flow, foveal avascular zone (FAZ), retinal thickness, and vascular density were measured at baseline. Three months after treatment, OCTA was repeated, and the alteration in variables was analyzed. ResultsThe FAZ area remained unchanged following treatment, (P = 0.75). Retinal thickness increased along (P = 0.02) with an increase in vascular density in the superficial and deep foveal area and the macular temporal sector (P = 0.007, 0.03 and 0.049, respectively). Choroidal flow surface area was unchanged (P = 0.10). ConclusionIn this study, foveal vascular density increased and FAZ remained unchanged after PRP for diabetic retinopathy.

Improved Macular Capillary Flow on Optical Coherence Tomography Angiography After Panretinal Photocoagulation for Proliferative Diabetic Retinopathy

This study evaluated the macular microvascular changes in eyes with proliferative diabetic retinopathy (PDR) following panretinal photocoagulation (PRP). Using optical coherence tomographic angiography (OCTA), we prospectively studied 10 eyes of 10 subjects with high-risk PDR immediately before, at 1month, and at 3-6months following PRP, using a 3-× 3-mm OCTA scan at each visit. The following parameters were calculated for the superficial (SCP), middle (MCP), and deep capillary plexuses (DCP): parafoveal vessel density (VD), adjusted flow index (AFI), and percent area of nonperfusion (PAN). Parafoveal SCP vessel-length density (VLD) was also evaluated. We performed univariate and multivariable statistics, adjusting for age and signal strength. To model the hemodynamic effect of PRP, we also present a mathematical model based on electrical circuits. We found no significant difference for the vascular density parameters following PRP, except for decreased density at the MCP at the latest timepoint in the adjusted multivariable model. PAN, a metric of nonperfusion adjusted for noise, and AFI, a surrogate metric of blood flow, showed significant increases at all capillary levels in the adjusted model. Our mathematical model explained how PRP would increase macular blood flow. Using OCTA, we found an overall increase in the flow metrics of all capillary layers in the macula following PRP, unrelated to macular edema or thickening, in line with the mathematical model. Our results suggest an overall redistribution of blood flow to the posterior pole following PRP, adding a new dimension to our understanding of the complex biologic effects of PRP in PDR. NOTE: Publication of this article is sponsored bythe American Ophthalmological Society.

The Effect of Panretinal Photocoagulation (PRP) versus Intravitreal Bevacizumab (IVB) Plus PRP on Peripapillary Retinal Nerve Fiber Layer (RNFL) Thickness Analyzed by Optical Coherence Tomography in Patients with Proliferative Diabetic Retinopathy.

Purpose:The current study aimed to evaluate changes in peripapillary retinal nerve fiber layer (RNFL) thickness in diabetic patients with bilateral proliferative diabetic retinopathy (PDR) after receiving panretinal photocoagulation (PRP) or intravitreal bevacizumab (IVB) with PRP.Methods:Ocular examination and peripapillary optical coherent tomography (OCT) were performed for each patient at baseline, 1, 3, 6, and 10 months after treatment. Both eyes of each patient were randomized into either PRP or PRP + IVB group.Results:Sixty-four eyes (32 patients) were enrolled in this randomized clinical trial. In the PRP group, global RNFL thickness initially increased and reached statistical significance in the third month (from 105.9 ± 21.4μm at baseline to 119 ± 41.6μm at 3 months, P = 0.03). Subsequent decline was observed with no significant difference from baseline at 10 months (106 ± 19.3μm, P = 0.914). There were no statistically significant changes in the PRP + IVB group (from 101.7 ± 22.2μm at baseline to 109.3 ± 26.9μm at 3 months, P = 0.996 and 101.9 ± 16.5μm at 10 months, P = 0.999). In the latter group, slight increase in RNFL thickness was observed in the first month (107.7 ± 21.1μm). RNFL thickness was similar to baseline in the two groups at month 10, with the exception of significant increase in superior-temporal sector in the PRP group (145.3 ± 13.4μm vs. 127.2 ± 17.3μm, P = 0.045).Conclusion:Compared to eyes treated with PRP, eyes treated with adjunctive IVB showed less significant post-treatment changes in RNFL thickness.

Comparative study between single session pattern short pulse laser and conventional pan-retinal photocoagulation regarding efficacy and macular thickening in patients with diabetic retinopathy

Aim: The aim of this study is to compare the effect of pan-retinal photocoagulation (PRP) using short-pulse laser (SPL) performed in a single session and conventional laser, regardless of the number of spots, in terms of their effect on the progression of diabetic macular edema (DME) and efficacy of regression of signs in patients with proliferative and high-risk nonproliferative diabetic retinopathy (NPDR). Methods: A prospective comparative case series was carried out, in which eyes with a similar degree of severe nonPDR or high-risk PDR underwent four-session PRP using a conventional laser in one eye (Group a) and a single session SPL in the other eye (Group b). After the session, colored photographs were taken to show immediate laser reaction. A follow-up visit was scheduled at 6 weeks to detect any complication. Finally, fluorescein angiography and optical coherence tomography were repeated at 3 months to assess the efficacy of laser treatment and the remeasure the macular thickness. Best-corrected visual acuity (BCVA) was remeasured after 12 weeks and compared to the prelaser VA. Results: The 20 patients included had a mean age of 53.4 ± 6.4 years. All patients had hemoglobin A1c (HBA1c) ranging from 7.2 to 8.4 with a mean of 7.7 ± 0.5. Before PRP initiation, there was no statistically significant difference between the two groups as regards mean age, duration of DM, and mean HBA1c. The mean power of laser was 198.7 ± 13.26 mW and 393.2 ± 17.7 mW (P