Changes in choriocapillaris and retinal morphology after laser photocoagulation by OCT angiography

Iwase, Takeshi; Ueno, Yoshitaka; Ra, Eimei; Ito, Yasuki; Terasaki, Hiroko

doi:10.1097/md.0000000000013278

Cited by 5 publications

(4 citation statements)

References 11 publications

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“…In addition, it has been reported that the amount of inflammatory cytokines induced following its treatment was lower than that of the conventional methods [77]. Finally, the operation time could be shortened, a significant point during the surgery [78,79]. Despite these benefits, the pattern scan laser has a narrow safety margin because of the short-pulse laser features and is easily influenced by hazy media such as vitreous hemorrhage.…”

Section: Treatment For Drmentioning

confidence: 99%

Updates on the Current Treatments for Diabetic Retinopathy and Possibility of Future Oral Therapy

Tomita

Lee

Ohta³

et al. 2021

JCM

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Diabetic retinopathy (DR) is a complication of diabetes and one of the leading causes of vision loss worldwide. Despite extensive efforts to reduce visual impairment, the prevalence of DR is still increasing. The initial pathophysiology of DR includes damage to vascular endothelial cells and loss of pericytes. Ensuing hypoxic responses trigger the expression of vascular endothelial growth factor (VEGF) and other pro-angiogenic factors. At present, the most effective treatment for DR and diabetic macular edema (DME) is the control of blood glucose levels. More advanced cases require laser, anti-VEGF therapy, steroid, and vitrectomy. Pan-retinal photocoagulation for non-proliferative diabetic retinopathy (NPDR) is well established and has demonstrated promising outcomes for preventing the progressive stage of DR. Furthermore, the efficacy of laser therapies such as grid and subthreshold diode laser micropulse photocoagulation (SDM) for DME has been reported. Vitrectomy has been performed for vitreous hemorrhage and tractional retinal detachment for patients with PDR. In addition, anti-VEGF treatment has been widely used for DME, and recently its potential to prevent the progression of PDR has been remarked. Even with these treatments, many patients with DR lose their vision and suffer from potential side effects. Thus, we need alternative treatments to address these limitations. In recent years, the relationship between DR, lipid metabolism, and inflammation has been featured. Research in diabetic animal models points to peroxisome proliferator-activated receptor alpha (PPARα) activation in cellular metabolism and inflammation by oral fenofibrate and/or pemafibrate as a promising target for DR. In this paper, we review the status of existing therapies, summarize PPARα activation therapies for DR, and discuss their potentials as promising DR treatments.

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Section: Treatment For Drmentioning

confidence: 99%

Updates on the Current Treatments for Diabetic Retinopathy and Possibility of Future Oral Therapy

Tomita

Lee

Ohta³

et al. 2021

JCM

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“…But Perry et al [32] demonstrated a recovery of the capillary integrity in feline eyes after laser photocoagulation. A study of laser lesions of OCTA also showed that recovery continued with time in some lasered spots [33]. In this study, no significant difference was found in vessel density of CCP between eyes with and without PRP in part of grids.…”

Section: Discussionmentioning

confidence: 42%

Comparison of Chorioretinal Parameters in Diabetic Retinopathy with or without Pan-Retinal Photocoagulation Using Ultrawide-Field Swept-Source Optical Coherence Tomography Angiography

Liu

Rao

et al. 2023

Ophthalmic Res

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Purpose To compare structural and vascular parameters in the central and peripheral retina and choroid of eyes diagnosed with severe non-proliferative diabetic retinopathy (NPDR) or proliferative diabetic retinopathy (PDR) with or without pan-retinal photocoagulation (PRP) using ultrawide-field wept-source optical coherence tomography angiography (SS-OCTA). Methods All participants underwent SS-OCTA imaging centered on the fovea. Retinal and choroidal thickness, vessel density of the superficial capillary plexus (SCP), deep capillary plexus (DCP), choroidal capillary plexus (CCP), and choroidal Sattler’s and Haller’s layer (CSHL) were analyzed in nine grids using built-in angiography analysis software. Results A total of 82 eyes from 82 participants were enrolled in this study, including 40 eyes diagnosed with severe NPDR or PDR without PRP and 42 eyes with PRP. Retinal thickness in part grids was higher in eyes with PRP than in eyes without PRP. Vessel density of the SCP in nasal-superior (P = 0.003) grid was lower in eyes with PRP than in eyes without PRP. No significant difference was found in the vessel density of the DCP between the two groups (all P > 0.05). The choroidal thickness and vessel density of the CSHL of all grids significantly lower in eyes with PRP than in eyes without PRP (all P < 0.05). A statistically significant decrease in vessel density in CCP was found in the superior (P = 0.043), nasal-superior grid (P = 0.003), macular grid (P < 0.001), and optic disc grid (P = 0.001) of eyes with PRP, compared to eyes without PRP. A significant decrease in the vessel density of CSHL was observed in all grids of PDR eyes with PRP compared to PDR eyes without PRP (all P < 0.05). Significant decrease in choroidal thickness was observed in most grids of PDR eyes with PRP, except for macular grid (P = 0.090) and optic disc grid (P = 0.057). Conclusion Structural and vascular parameters in the central and peripheral retinal and choroidal layers in eyes diagnosed with severe NPDR or PDR with or without PRP could be quantified using a ultrawide-field SS-OCTA. Eyes with PRP showed a significant decrease in choroidal thickness and vessel density of CCP and CSHL, compared with eyes without PRP. This trend was more obvious in eyes with PDR.

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“…The restoration can be observed in human eye using high-resolution OCT or OCT angiography. [43] In addition, Hiroshiba et al reported that the leukocyte velocities in the retinal capillaries were significantly decreased immediately after photocoagulation and then gradually recovered to normal as time elapsed. [29] Those results suggest that the retinal blood flow is reduced immediately after laser photocoagulation as the above mechanism, but it can be recovered gradually with the restoration of the outer retinal layer, probably the increased retinal oxygen tension is reduced because of restoration of outer retina.…”

Section: Discussionmentioning

confidence: 99%

Evaluation of blood flow on optic nerve head after pattern scan and conventional laser panretinal photocoagulation

Iwase¹,

Mikoshiba²,

Ra³

et al. 2019

Medicine

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To evaluate the changes in the blood flow on retina and the optic nerve head (ONH) after conventional laser treatment and to compare it to that after patterned scanning laser (PASCAL) treatment in patients with severe nonproliferative diabetic retinopathy (S-NPDR). In this prospective, cross-sectional study, the blood flow on retina and the ONH was assessed by laser speckle flowgraphy using the mean blur rate (MBR) in 39 eyes with S-NPDR before, 1, 4, 8, 12 weeks after panretinal photocoagulation (PRP). Of 39 eyes, 17eyes with 17 patients treated by conventional laser and 22 eyes with 22 patients treated by PASCAL. The mean age was 55.5 ± 11.5 years in the conventional laser group, 55.6 ± 11.8 years in the PASCAL group. The MBR-vessel, which can be dominantly expressed as retinal blood flow, was significantly reduced after PRP treated by conventional laser ( P < .001), but did not change after PRP treated by PASCAL. The ratio of MBR-vessel to the baseline was significantly lower in the conventional laser group only at Week 1 ( P = .045). The MBR-tissue, which can be dominantly expressed as the ONH blood flow, did not significantly change after PRP in the both group. The multiple stepwise regression analysis revealed that the laser burns was an independent factor significantly correlated with the ratio of MBR-vessel at Week 1 to the baseline ( β = −0.550, P = .012). The retinal blood flow was significantly reduced during the 12 weeks only after completion of PRP by conventional laser treatment. Our results indicate that short pulse on PRP treatment performed by the PASCAL would not significantly reduce the retinal blood flow.

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Changes in choriocapillaris and retinal morphology after laser photocoagulation by OCT angiography

Cited by 5 publications

References 11 publications

Updates on the Current Treatments for Diabetic Retinopathy and Possibility of Future Oral Therapy

Updates on the Current Treatments for Diabetic Retinopathy and Possibility of Future Oral Therapy

Comparison of Chorioretinal Parameters in Diabetic Retinopathy with or without Pan-Retinal Photocoagulation Using Ultrawide-Field Swept-Source Optical Coherence Tomography Angiography

Evaluation of blood flow on optic nerve head after pattern scan and conventional laser panretinal photocoagulation

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