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

Mirshahi, Ahmad; Ghassemi, Fariba; Fadakar, Kaveh; Mirshahi, Reza; Bazvand, Fatemeh; Riazi-Esfahani, Hamid

doi:10.1016/j.joco.2019.06.001

Cited by 23 publications

(11 citation statements)

References 35 publications

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“…3 B). Conversely, our analyses did not reveal any significant alteration in the FAZ area following PRP, which was consistent with previous literature 25 , 26 . Lorusso et al 26 in a similar study, investigated the alteration of OCTA parameters following PRP.…”

Section: Discussionsupporting

confidence: 93%

“…Fawzi et al 24 reported an overall increase in the OCTA flow metrics of all capillary layers in the macula, 6 months after PRP. Mirshahi et al 25 reported that foveal vascular density, measured using OCTA, increased 3 months after PRP. In the current study, decrease of PD and VLD, 1 month after PRP implies the effect of acute inflammation of the retinal tissue, subsequent to laser treatment.…”

Section: Discussionmentioning

confidence: 99%

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Longitudinal changes in retinal microvasculature after panretinal photocoagulation in diabetic retinopathy using swept-source OCT angiography

Kim

2021

Sci Rep

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This study evaluated quantitative changes in microvascular parameters after panretinal photocoagulation (PRP) in diabetic retinopathy (DR), using swept-source OCT Angiography (SS-OCTA). A total of 27 treatment-naïve eyes were subjected to PRP and followed-up for > 12 months after the procedure. Foveal avascular zone (FAZ) area, macular perfusion density (PD), and vessel length density (VLD) were calculated on a 3 × 3 mm en face OCTA image and nonperfusion area (NPA) was obtained on a 12 × 12 mm en face OCTA image. One month after PRP, PD and VLD of superficial and deep capillary plexus decreased and subsequently, increased progressively across the next 12 months, with statistically significant differences (P = 0.015 and 0.02). Continuous decreasing trends in total NPA values was observed across 12 months after PRP (P = 0.125). A difference in PD of the superficial capillary plexus between baseline and 6 months post PRP, was significantly associated with the progression of DR, 12 months after PRP (OR 0.528; P = 0.025). We found significant longitudinal retinal microvascular changes after PRP in DR. Overall macular perfusion status was impaired and progressively recovered across the next 12 months, compared to the baseline. Additionally, the early treatment responses in PD can predict the long-term outcomes of PDR after PRP.

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Section: Discussionsupporting

confidence: 93%

Section: Discussionmentioning

confidence: 99%

Longitudinal changes in retinal microvasculature after panretinal photocoagulation in diabetic retinopathy using swept-source OCT angiography

Kim

2021

Sci Rep

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“…Some studies of DR have reported a deterioration of OCTA parameters as the stage of DR progresses 17 – 21 . In addition, studies of macular perfusion status after PRP have been actively reported 22 – 25 ; however, the sample sizes were relatively small and the follow-up periods were short in most studies. To the best of our knowledge, no previous study has investigated the relationship between OCTA parameters and systemic factors in patients with DR.…”

Section: Introductionmentioning

confidence: 99%

Factors predicting final visual outcome in quiescent proliferative diabetic retinopathy

Park

Kwon

2020

Sci Rep

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To investigate factors reflecting visual outcome and macular perfusion in quiescent proliferative diabetic retinopathy (PDR) patients after panretinal photocoagulation (PRP). We included 118 patients with quiescent PDR who had completed PRP. All participants had standardized interview to determine ocular history, smoking status, cardiovascular risk factors, and history of diabetic mellitus (DM). Foveal avascular zone (FAZ) area, retinal vessel density (VD) and vessel length density (VLD) were measured using optical coherence tomography angiography. VD was negatively correlated with hypertension, diabetic foot, HbA1c, and time after PRP (β = − 0.181, P = 0.046; β = − 0.231, P = 0.020; β = − 0.244, P = 0.010; β = − 0.278, P = 0.029). FAZ area of superficial capillary plexus and deep capillary plexus (DCP) was positively correlated with DM duration and diabetic foot (β = 0.178, P = 0.047; β = 0.293, P = 0.002; β = 0.252, P = 0.045; β = 0.304, P = 0.002). Macular perfusion state in patients with quiescent PDR was associated with diabetic foot, DM duration, HbA1c, and time after PRP. Of note, diabetic foot showed the strongest correlation with macular perfusion among various systemic factors. VLD, especially in DCP was associated with poor visual outcome.

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“…In clinical practice, however, there is no consensus on when PRP should be administrated if anti-VEGF treatment is combined [ 9 – 11 ]. On one hand, PRP decreases metabolic demand in the peripheral retina and alleviates the ischemia that drives neovascularization [ 12 ], it is unknown whether or not standard PRP could reduce the number of anti-VEGF injection in the long run. On the other hand, PRP may aggravate macular edema due to retinal inflammation and increased vascular permeability [ 13 ], it is also unknown whether this PRP-induced macular damage is temporary or permanent.…”

Section: Introductionmentioning

confidence: 99%

Panretinal photocoagulation after or prior to intravitreal conbercept injection for diabetic macular edema: a retrospective study

et al. 2021

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Background Panretinal photocoagulation treatment (PRP) have been known as a standard treatment for proliferative diabetic retinopathy (PDR) or severe nonproliferative diabetic retinopathy (sNPDR). However, there is no consensus on when PRP should be administrated if anti-VEGF treatment is needed for the concurrent diabetic macular edema (DME). This study is to evaluate the difference between two groups of PRP prior to, or after intravitreal conbercept (IVC) for patients with PDR or sNPDR combined with DME. Methods This was a retrospective study. Fifty-eight eyes with DME secondary to PDR or sNPDR were divided into two groups; the PRP after (PRP-after group), or prior to (PRP-prior group), IVC. Changes in number of IVC injections, best corrected visual acuity (BCVA), and central subfield macular thickness (CSMT) were compared after 4 weeks, 12 weeks, 1 year, and 2 years from the first IVC injection. Results The mean number of injections in PRP-after group was 4.8 (1 year) and 6.4 (2 year), lower than 6.4 (1 year) and 8.5 (2 year) in PRP-prior group (both p = 0.002). There was no significant difference in change in BCVA and CSMT between two groups after each follow-up. Conclusion PRP after IVC requires less injections but also yields similar visual and anatomic outcome comparing with PRP prior to IVC in patients with diabetic retinopathy combined with DME.

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

Cited by 23 publications

References 35 publications

Longitudinal changes in retinal microvasculature after panretinal photocoagulation in diabetic retinopathy using swept-source OCT angiography

Longitudinal changes in retinal microvasculature after panretinal photocoagulation in diabetic retinopathy using swept-source OCT angiography

Factors predicting final visual outcome in quiescent proliferative diabetic retinopathy

Panretinal photocoagulation after or prior to intravitreal conbercept injection for diabetic macular edema: a retrospective study

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