Long-Term Temporal Changes of Peripapillary Retinal Nerve Fiber Layer Thickness Before and After Panretinal Photocoagulation in Severe Diabetic Retinopathy

Kim, Jongshin; Woo, Se Joon; Ahn, Jeeyun; Park, Ki Ho; Chung, Hum; Park, Kyu Hyung

doi:10.1097/iae.0b013e3182562000

Cited by 38 publications

(34 citation statements)

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“…Although a decreasing trend was observed, the average and all quadrants RNFL thicknesses at each follow-up increased significantly from the baseline. However, several previous studies showed that there were no significant changes in the RNFL thickness for the average, superior, inferior and nasal quadrants between the baseline and 1 year post-PRP 15 16. These inconsistent results could be explained by the use of different OCT systems.…”

Section: Discussionmentioning

confidence: 91%

One-year follow-up of macular ganglion cell layer and peripapillary retinal nerve fibre layer thickness changes after panretinal photocoagulation

Kim

Shin

et al. 2013

Br J Ophthalmol

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Section: Discussionmentioning

confidence: 91%

One-year follow-up of macular ganglion cell layer and peripapillary retinal nerve fibre layer thickness changes after panretinal photocoagulation

Kim

Shin

et al. 2013

Br J Ophthalmol

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“…The association between localized RNFLDs, and glaucoma and diabetic retinopathy also was described in cross-sectional studies. [3][4][5]13,17,20,21 The association between localized RNFLDs and arterial hypertension or cerebrovascular stroke has not often been described yet. 22,23 Kim et al 22 examined 4395 Korean subjects who underwent health checkups, including brain magnetic resonance imaging and fundus photography.…”

Section: Discussionmentioning

confidence: 99%

Ten-Year Incidence of Retinal Nerve Fiber Layer Defects: The Beijing Eye Study 2001/2011

Ren

Wang

et al. 2015

Invest. Ophthalmol. Vis. Sci.

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PURPOSE. We examined the 10-year incidence of localized retinal nerve fiber layer defects (RNFLDs) and associated factors in adult Chinese.METHODS. The population-based longitudinal Beijing Eye Study, which included 4439 subjects (age, 40þ years) in 2001, was repeated in 2011 with 2695 subjects participating (66.4% of the survivors). Color fundus photographs taken at baseline and 10 years later were examined for localized RNFLDs, defined as wedge-shaped defects running toward the optic disc.RESULTS. Fundus photographs were available for 2422 (89.9%) subjects. Incident-localized RNFLDs were detected in 114/2422 persons (4.7% 6 0.2%) or 139/4867 eyes (2.9% 6 0.2%). A total of 25 (22%) persons had incident-localized RNFLDs bilaterally, and 89 (78%) persons unilaterally. Among the 114 persons with incident RNFLDs, 78 persons showed newly developed localized RNFLDs, while 36 subjects showed an enlargement of a preexisting localized RNFLD. In binary logistic regression analysis, a higher 10-year incidence of localized RNFLDs was significantly associated with a higher prevalence of arterial hypertension (P ¼ 0.002; odds ratio [OR], 2.31; 95% confidence interval (CI), 1.35, 3.97), higher diastolic blood pressure (P ¼ 0.02; OR, 1.02; 95% CI, 1.004,1.04), higher prevalence of previous cerebrovascular infarctions (P ¼ 0.007; OR, 2.61; 95% CI, 1.30, 5.22), younger age (P ¼ 0.01; OR, 0.97; 95% CI, 0.94, 0.99), higher prevalence of diabetic retinopathy (P ¼ 0.001; OR, 4.70; 95% CI, 1.92, 11.5), higher prevalence of open-angle (P < 0.001; OR, 39.8; 95% CI, 19.7, 80.5) and angle-closure (P < 0.001; OR, 21.3; 95% CI, 7.90, 57.5) glaucoma, and thinner retinal nerve fiber layer (P < 0.001; OR, 0.97; 95% CI, 0.95, 0.98).CONCLUSIONS. The 10-year incidence of localized RNFLDs in adult Chinese is 4.7% 6 0.2%. It is strongly associated with arterial hypertension and higher prevalence of cerebrovascular infarcts, in addition to ocular reasons, such as glaucoma and diabetic retinopathy. Ophthalmologically normal subjects with incident-localized RNFLDs may be screened for arterial hypertension and cerebrovascular infarcts.Keywords: retinal nerve fiber layer, stroke, glaucoma, optic nerve, optic disc, Beijing Eye Study T he optic nerve as cerebral fascicle has its origin in the retinal ganglion cell layer. Its axons extend from the inner retina through the optic disc, optic nerve, and optic tract to the lateral geniculate ganglion. Any optic nerve damage affects the retinal nerve fiber layer (RNFL) through the loss of optic nerve fibers. The RNFL has conventionally been examined by ophthalmoscopy or on color fundus photographs. [1][2][3][4][5] The visibility of the RNFL shows a specific pattern with usually the best visibility in the temporal inferior arcade, followed by the temporal superior arcade, nasal superior arcade, and nasal inferior arcade. 6 The distribution of the RNFL visibility correlates with the thickness of the RNFL as measured by histomorphometry or confocal scanning laser tomography, with the diameter of the retinal arter...

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“…After primary laser injury, the laser scar lesions may coalesce, leading to functional damage such as visual field defects and if involving the macula, visual disturbance [2][3][4]. There may be discernible changes to the optic nerve head [1,[4][5][6][7][8][9]. Consequently, it is difficult to ascertain whether an increasing CDR in post PRP treated eyes is due to glaucoma, diabetes related ischemia or simply a non-progressive injury secondary to the PRP itself.…”

Section: Introductionmentioning

confidence: 95%

“…Consequently, it is difficult to ascertain whether an increasing CDR in post PRP treated eyes is due to glaucoma, diabetes related ischemia or simply a non-progressive injury secondary to the PRP itself. Past studies used unsophisticated or non-dedicated imaging to measure retinal nerve fiber layers (RNFL) [1,4,5,[7][8][9][10][11][12][13][14][15][16][17]. Ours is the first to use highly reproducible High Definition Spectral Domain Optical Coherence Tomography (SDOCT) of the optic nerve head (ONH) by both Cirrus (Carl Zeiss Meditec Inc, Dublin, CA) and Spectralis (Heidelberg Engineering, Heidelberg Germany).…”

Section: Introductionmentioning

confidence: 99%

The Effects of PASCAL Panretinal Photocoagulation on the Peripapillary Retinal Nerve Fiber Layer

Mohla¹,

Mathur²

2016

J Clin Exp Ophthalmol

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Purpose: To investigate the effects of Pascal (Topcon Medical Laser Systems, Inc. Oakland, NJ) pan-retinal photocoagulation (PRP) on the optic nerve head (ONH).Method: This was a prospective case control study comparing 3 groups of patients seen in the diabetic retinopathy (DR) clinics, without any coexistent optic nerve pathology.Group A patients had proliferative or severe non proliferative DR necessitating PRP during the study period. Group B patients had mild or moderate DR and did not require PRP throughout the study period. Group C patients had standard retinal laser (green argon or frequency doubled YAG) PRP at least 2 years ago. All the 3 Groups had retinal oxygenation measurements and retinal vessel caliber readings by Oxymap T1(Oxymap, Reykjavik, Iceland), optic disc stereophotographs, high definition optical coherence tomography (HD-OCT) scans of the ONH by both Cirrus (Carl Zeiss Meditec Inc, Dublin, CA) and Spectralis (Heidelberg Engineering, Heidelberg Germany). These were performed prior to PRP at baseline, then at 3, 6, and 12 months post PRP for group A and at baseline, 3, 6, and 12 months for groups B and C. Paired t-test was used to assess the mean changes in parameters from baseline for each group.Results: A total of 90 patients were recruited including 27 in Group A, 31 in Group B and 32 in Group C. At baseline, the average retinal nerve fibre layer (RNFL) was significantly thicker in group A compared to group B (102.0 ± 16.8 vs. 89.5 ± 11.6 μm, p=0.001) and group C (88.6 ± 11.2 μm, p=0.001) respectively. At 3 months, Group A exhibited a significant increase in the Cirrus average RNFL thickness (5.60 ± 8.54 µ, p=0.003) when compared to baseline. At 6 months, the average RNFL reverted to baseline values (p=0.89), and remained stable at 12 months (p=0.85). There was no significant change noted in the average Cirrus RNFL thickness at 3 and 6 months in Group B. At 12 months, the average RNFL was significantly thinner compared to baseline (-6.68 ± 8.10; p=0.005). In Group C, the average RNFL remained stable from baseline through to month 12 (p>0.05 at the three timepoints). No significant changes were noted in the average Spectralis RNFL thickness at any timepoints in each of the three groups.Oxygen saturation dropped in all 3 groups at 3 months, being significant only in group B (-2.05 ± 4.20%, p=0.03). Conclusion:In eyes treated with Pascal PRP, there was an initial increase in the retinal nerve fibre layer at the optic nerve head at 3 months followed by a thinning back to baseline values at 6 months which then remained stable up to 12 months. Hence the Pascal PRP did not have a significant effect on the nerve fibre layer at 12 months.Keywords: Pascal panretinal photocoagulation; Optic nerve head; Retinal nerve fibre layer thickness; Retinal oximetry; Diabetic retinopathy SummaryIn this study, we investigated the effects of Pascal (Topcon Medical Laser Systems, Inc. Oakland, NJ) pan-retinal photocoagulation (PRP) on the optic nerve head (ONH). This was a prospective case control study c...

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Long-Term Temporal Changes of Peripapillary Retinal Nerve Fiber Layer Thickness Before and After Panretinal Photocoagulation in Severe Diabetic Retinopathy

Cited by 38 publications

References 13 publications

One-year follow-up of macular ganglion cell layer and peripapillary retinal nerve fibre layer thickness changes after panretinal photocoagulation

One-year follow-up of macular ganglion cell layer and peripapillary retinal nerve fibre layer thickness changes after panretinal photocoagulation

Ten-Year Incidence of Retinal Nerve Fiber Layer Defects: The Beijing Eye Study 2001/2011

The Effects of PASCAL Panretinal Photocoagulation on the Peripapillary Retinal Nerve Fiber Layer

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