Argon Laser Panretinal Photocoagulation for Diabetic Retinopathy

Dj, Wilson; Wr, Green

doi:10.1001/archopht.1987.01060020093036

Cited by 39 publications

(12 citation statements)

References 21 publications

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“…It has been reported that photocoagulation essentially destroyed the choriocapillaris 14,25,26 , and the heat dissipates from the RPE to the adjacent outer retina 24 . Thus, a large number of these cells are destroyed after the many photocoagulation burns by PRP.…”

Section: Discussionmentioning

confidence: 99%

A randomized clinical trial evaluating choroidal blood flow and morphology after conventional and pattern scan laser panretinal photocoagulation

Mikoshiba

Iwase

Ueno

et al. 2018

Sci Rep

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We prospectively investigated the changes in choroidal blood flow and morphology after panretinal photocoagulation (PRP) in 39 eyes with severe nonproliferative diabetic retinopathy (S-NPDR). Seventeen eyes underwent PRP by conventional laser and 22 eyes underwent pattern scan laser (PASCAL). The choroidal blood flow was assessed by laser speckle flowgraphy, and the subfoveal choroidal thickness (SFCT) was measured with optical coherence tomography before and 1, 4, 8, and 12 weeks after the two types of PRP treatments. The choroidal mean blur rate (MBR) at the macular region was significantly reduced to 86.4% of the baseline level in the conventional laser group and 85.7% in the PASCAL group at Week 12 (P = 0.001, P < 0.001, respectively). The SFCT was significantly increased at 1 week following PRP but it was significantly reduced at Week 8 (P = 0.001, P < 0.001, respectively) in both groups. The differences in the ratio of the MBR and the SFCT was not significant between the conventional laser and PASCAL groups at any time after PRP. The results suggest that appropriate PRP treatments even by the PASCAL method will reduce the choroidal blood flow and the choroidal morphological components.

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Section: Discussionmentioning

confidence: 99%

A randomized clinical trial evaluating choroidal blood flow and morphology after conventional and pattern scan laser panretinal photocoagulation

Mikoshiba

Iwase

Ueno

et al. 2018

Sci Rep

View full text Add to dashboard Cite

show abstract

“…A previous study [ 28 ] found that retinal photocoagulation directly affects the choriocapillaris. However, changes to choroidal circulation following photocoagulation remain controversial [ 29 ], since a study using scanning electron microscopy found no damage in large vessels in the deeper choroid following retinal photocoagulation [ 30 ]. We found no significant changes in the CC+MCVLT before and after hemodialysis in both groups.…”

Section: Discussionmentioning

confidence: 99%

Choroid structure analysis following initiation of hemodialysis by using swept-source optical coherence tomography in patients with and without diabetes

et al. 2020

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We aimed to evaluate choroid structural changes using swept-source optical coherence tomography (SS-OCT) following hemodialysis initiation in diabetic and nondiabetic patients with end-stage kidney disease (ESKD). In this multicenter, prospective, cross-sectional study, diabetic (DM group; 30 eyes; 16 patients) and nondiabetic patients (NDM group; 30 eyes; 15 patients) with ESKD were evaluated after hemodialysis initiation. SS-OCT findings were analyzed using a manual delineation technique and binarization method before the first and last hemodialysis sessions, conducted approximately 2 weeks apart. Subfoveal choroidal thickness changes and mean large choroidal vessel layer thickness were significantly greater in the DM group (−13.3% ± 2.5% and −14.5% ± 5.2%, respectively) than the NDM group (−9.5% ± 3.1% and −9.2% ± 3.4%, respectively; p = 0.049 and p = 0.02, respectively). Binarized SS-OCT analysis revealed that the mean subfoveal choroidal area was significantly larger in the DM group (−21.9% ± 6.5%) than the NDM group (−17.2% ± 5.9%; p = 0.032). The change ratio in mean luminal area values was significantly greater in the DM group (−27.7% ± 8.7%) than the NDM group (−17.7% ± 5.8%; p = 0.007). The DM group exhibited substantial changes in the choroidal layer, possibly reflecting choroidal vascular disorders caused by diabetes.

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“…[34] Histologic damage to the choriocapillaris in humans have also been reported for such lesions. [35, 36] Morphological studies have reported that the outer nuclear layer, the high oxygen-consuming photoreceptor cells, and RPE were absent following PRP along with obliteration of the choriocapillaris,[35–37] suggesting that the ocular blood flow in the photocoagulated area decreases after PRP. Our OCT and OCT angiography map clearly demonstrates the long-term disruption of photoreceptor cells, RPE, and choriocapillaris in burn regions following PRP (Fig 6), corroborating these histologic findings.…”

Section: Discussionmentioning

confidence: 99%

Effects of photocoagulation on ocular blood flow in patients with severe non-proliferative diabetic retinopathy

et al. 2017

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PurposeTo investigate ocular blood flow and correlations between ocular blood flow and variables in patients with severe non-proliferative diabetic retinopathy (S-NPDR) following panretinal photocoagulation (PRP).MethodsIn this retrospective, cross-sectional study, the blood flow on the optic nerve head (ONH) and choroid was assessed with laser speckle flowgraphy (LSFG) using the mean blur rate (MBR) in 76 eyes of 76 patients with S-NPDR who underwent PRP, 39 eyes of 39 patients with S-NPDR who did not undergo PRP, and 71 eyes of 71 normal subjects. The correlation between MBR and variables, including visual acuity (VA) and choroidal area determined by binarization method, was analyzed.ResultsThe mean age was 62.9 ± 11.9 years in the S-NPDR with PRP eyes, 55.6 ± 11.4 years in the S-NPDR without PRP eyes, and 60.3 ± 11.1 years in the normal subject eyes. The ONH MBR in vessel and tissue areas and the choroidal MBR were significantly lower in the S-NDR with PRP group than in the other groups (p < 0.001, p < 0.001, and p < 0.001, respectively). The luminal and the stromal areas were significantly smaller in the S-NDR with PRP group than in the other groups (p < 0.001 and p < 0.001, respectively). LogMAR best corrected visual acuity (BCVA) exhibited significant negative correlation with the ONH MBR in vessel (r = −0.386, p < 0.001), tissue (r = −0.348, p < 0.001), and the choroid MBR (r = −0.339, p = 0.002) in the S-NDR with PRP group. Stepwise multiple regression analysis demonstrated that BCVA was a common independent factor associated with the ONH MBR in vessel, tissue, and the choroidal MBR in the S-NDR with PRP group.ConclusionsONH and choroid MBR in addition to choroidal component, including the luminal area, were significantly lower in eyes of patients with S-NPDR after PRP compared with no PRP and normal subjects group. This could suggest that the significantly reduced ocular blood flow in PRP-treated S-NPDR eyes correlated with long-term decreased post-PRP luminal area and visual acuity.

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Argon Laser Panretinal Photocoagulation for Diabetic Retinopathy

Cited by 39 publications

References 21 publications

A randomized clinical trial evaluating choroidal blood flow and morphology after conventional and pattern scan laser panretinal photocoagulation

A randomized clinical trial evaluating choroidal blood flow and morphology after conventional and pattern scan laser panretinal photocoagulation

Choroid structure analysis following initiation of hemodialysis by using swept-source optical coherence tomography in patients with and without diabetes

Effects of photocoagulation on ocular blood flow in patients with severe non-proliferative diabetic retinopathy

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