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RetinaJune 20167 citations

RETINAL MORPHOMETRY CHANGES MEASURED WITH SPECTRAL DOMAIN-OPTICAL COHERENCE TOMOGRAPHY AFTER PAN-RETINAL PHOTOCOAGULATION IN PATIENTS WITH PROLIFERATIVE DIABETIC RETINOPATHY.

Mitsch Christoph, Pemp Berthold, Kriechbaum Katharina, Bolz Matthias, Scholda Christoph, Schmidt-Erfurth Ursula


AI Summary

PRP for PDR causes early retinal nerve fiber layer swelling and late photoreceptor/RPE thinning, indicating diffuse inflammation and morphometric changes detectable by OCT.

Abstract

Purpose

To identify the effects of pan-retinal laser treatment on the integrity of neurosensory retinal layers.

Methods

Patients were examined with fluorescence angiography after a standardized examination for diabetic retinopathy and a peripapillary ring scan with spectral domain optical coherence tomography. A single-session pan-retinal photocoagulation was performed using the PASCAL pattern scanning argon laser applying a minimum of 1,500 spots. Optical coherence tomography was evaluated more than 6 months.

Results

Eighteen eyes of 12 consecutive patients with new onset, treatment-naive proliferative diabetic retinopathy secondary to diabetes Type 2 were treated and retinal optical coherence tomography morphology evaluated. Retinal nerve fiber layer thickness increased statistically significantly from baseline to week 1, when it reached its peak. The combined thickness of the outer plexiform and the inner nuclear layers and the combined thickness of the inner plexiform and the ganglion cell layers showed no relevant changes. The combined thickness of the retinal pigment epithelium and the photoreceptor cell layers decreased at month 1 followed by a steady increase in thickness, which remained below baseline values over time.

Conclusion

Pan-retinal photocoagulation in proliferative diabetic retinopathy leads to a slowly reversible, marked biological response with statistically significant morphometric changes detected by spectral domain optical coherence tomography. Swelling of the retinal nerve fiber and outer nuclear layers induce an increase in peripapillary total retinal thickness. Simultaneously, the photoreceptor and retinal pigment epithelium layers decrease in thickness. These changes indicate diffuse retinal inflammation after pan-retinal laser therapy.


MeSH Terms

AgedDiabetes Mellitus, Type 2Diabetic RetinopathyFemaleFluorescein AngiographyHumansLaser CoagulationLasers, GasMaleMiddle AgedNerve FibersPhotoreceptor Cells, VertebrateProspective StudiesRetinal Ganglion CellsRetinal Pigment EpitheliumTomography, Optical CoherenceVisual Acuity

Key Concepts4

Pan-retinal photocoagulation in 18 eyes of 12 consecutive patients with new onset, treatment-naive proliferative diabetic retinopathy secondary to diabetes Type 2 led to a statistically significant increase in retinal nerve fiber layer thickness from baseline to week 1, when it reached its peak, as measured by spectral domain optical coherence tomography.

PrognosisCase seriesn=18 eyes of 12 patientsCh5Ch19

Pan-retinal photocoagulation in 18 eyes of 12 consecutive patients with new onset, treatment-naive proliferative diabetic retinopathy secondary to diabetes Type 2 resulted in no relevant changes in the combined thickness of the outer plexiform and the inner nuclear layers, or the combined thickness of the inner plexiform and the ganglion cell layers, as measured by spectral domain optical coherence tomography.

PrognosisCase seriesn=18 eyes of 12 patientsCh5Ch19

Pan-retinal photocoagulation in 18 eyes of 12 consecutive patients with new onset, treatment-naive proliferative diabetic retinopathy secondary to diabetes Type 2 caused the combined thickness of the retinal pigment epithelium and the photoreceptor cell layers to decrease at month 1, followed by a steady increase in thickness that remained below baseline values over time, as measured by spectral domain optical coherence tomography.

PrognosisCase seriesn=18 eyes of 12 patientsCh5Ch19

Pan-retinal photocoagulation in proliferative diabetic retinopathy leads to a slowly reversible, marked biological response with statistically significant morphometric changes detected by spectral domain optical coherence tomography, including swelling of the retinal nerve fiber and outer nuclear layers inducing an increase in peripapillary total retinal thickness, and simultaneously, a decrease in thickness of the photoreceptor and retinal pigment epithelium layers, indicating diffuse retinal inflammation.

MechanismCase seriesn=18 eyes of 12 patientsCh5Ch19

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