Effect of Diabetic Retinopathy and Panretinal Photocoagulation on Retinal Nerve Fiber Layer and Optic Nerve Appearance

Lim, Michele C.; Tanimoto, S.A.; Furlani, Bruno; Lum, B.; Pinto, Luciano Ribeiro; Eliason, David; Prata, Tiago S.; Brandt, James D.; Morse, Lawrence S.; Park, Susanna Soon Chun; Melo, Luiz Alberto S.

doi:10.1001/archophthalmol.2009.135

Cited by 68 publications

(86 citation statements)

References 32 publications

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“…It is well documented that laser photocoagulation induces reduction of peripapillary RNFL thickness. 5,17 Because the number of children with previous severe ROP without laser treatment was too small to allow proper sub-analyses, it was impossible to clearly reveal whether laser treatment had an effect on RNFL thickness in this study. However, in univariate analysis, the presence of severe ROP showed a significant positive correlation with RNFL thickness in the temporal sector.…”

Section: Variablementioning

confidence: 95%

“…However, this analysis was performed only for global average RNFL thickness, and whether this result came from a direct effect of ROP itself or was a sequel of laser treatment could not be determined. Laser treatment has been reported to induce peripapillary RNFL thinning, 4,5 and most of the subjects in their study with severe ROP had previously received laser treatment.…”

Section: Introductionmentioning

confidence: 93%

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Retinal nerve fiber layer thickness in prematurity is correlated with stage of retinopathy of prematurity

2015

Eye

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Purpose To compare retinal nerve fiber layer (RNFL) thickness profiles between preterm and full-term children and to investigate factors affecting the RNFL distribution in preterm children.Methods We performed Spectral domain optical coherence tomography (SD-OCT) peripapillary RNFL circular scan centered on the optic disc in 50 premature and 58 full-term children. RNFL thickness profiles were compared between preterm and fullterm children using a linear regression model. Among preterm patients in this study, 20 patients previously received laser treatment for severe retinopathy of prematurity (ROP).Results Global average, nasal, and superior disc RNFL thickness profiles were significantly smaller in preterm children (92.70 ± 16.57 μm, 56.02 ± 17.04 μm, and 108.74 ± 27.36 μm, respectively) compared with full-term children (101.63 ± 9.21 μm, P = 0.006, 69.14 ± 14.15 μm, Po0.001, and superior, 129.11 ± 18.14 μm, Po0.001, respectively). Multivariable analysis revealed that ROP stage was inversely correlated with nasal RNFL thickness (P = 0.010).Conclusions Our SD-OCT data demonstrate decreased global average, nasal, and superior disc RNFL thicknesses in preterm children. ROP stage was inversely correlated with nasal RNFL thickness. Further studies are needed to better understand the association between these structural changes and visual functions in preterm children.

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Section: Variablementioning

confidence: 95%

Section: Introductionmentioning

confidence: 93%

Retinal nerve fiber layer thickness in prematurity is correlated with stage of retinopathy of prematurity

2015

Eye

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“…Due to rising life expectancies and the growing prevalence of diabetes, the incidence of DR is expected to grow by more than 70% by 2020 [1]. Pan retinal photocoagulation (PRP) is the accepted gold standard treatment for proliferative diabetic retinopathy and whilst necessary, may lead to unwanted collateral retinal damage.…”

Section: Introductionmentioning

confidence: 99%

“…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: 99%

“…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%

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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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Laser photocoagulation for proliferative diabetic retinopathy

Evans

Michelessi

Virgili

2014

Cochrane Database of Systematic Reviews

123

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This review provides evidence that laser photocoagulation is beneficial in treating proliferative diabetic retinopathy. We judged the evidence to be moderate or low, depending on the outcome. This is partly related to reporting of trials conducted many years ago, after which panretinal photocoagulation has become the mainstay of treatment of proliferative diabetic retinopathy.Future Cochrane Reviews on variations in the laser treatment protocol are planned. Future research on laser photocoagulation should investigate the combination of laser photocoagulation with newer treatments such as anti-vascular endothelial growth factors (anti-VEGFs).

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Effect of Diabetic Retinopathy and Panretinal Photocoagulation on Retinal Nerve Fiber Layer and Optic Nerve Appearance

Cited by 68 publications

References 32 publications

Retinal nerve fiber layer thickness in prematurity is correlated with stage of retinopathy of prematurity

Retinal nerve fiber layer thickness in prematurity is correlated with stage of retinopathy of prematurity

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

Laser photocoagulation for proliferative diabetic retinopathy

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