Longitudinal analysis of subfoveal choroidal thickness after panretinal laser photocoagulation in diabetic retinopathy using swept-source optical coherence tomography

Eleiwa, Kamel Taher; Bayoumy, Ahmed; Elhusseiny, Mahmoud Abdelrahman; Gamil, Khalid; Sharawy, Amr

doi:10.22336/rjo.2020.46

Cited by 6 publications

(4 citation statements)

References 23 publications

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“…A series of studies have shown a significant decrease in subfoveal choroidal thickness after PRP using enhanceddepth OCT [9,[21][22][23]. Our results were consistent with those of previous studies.…”

Section: Discussionsupporting

confidence: 93%

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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Section: Discussionsupporting

confidence: 93%

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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“…Before the introduction of intravitreal anti-VEGF agents, laser photocoagulation was the standard of care for DME treatment. It was introduced to the field of ophthalmology over 25 years ago [ 29 , 41 ]. In 1985, in the Early Treatment Diabetic Retinopathy Study (ETDRS), a multicenter randomized trial exploring the benefits of laser therapy for retinopathy, it was demonstrated that photocoagulation could halve the risk of moderate visual loss over three years from 24% to 12% compared to deferred treatment [ 42 ].…”

Section: Current Therapeuticsmentioning

confidence: 99%

Current and Novel Therapeutic Approaches for Treatment of Diabetic Macular Edema

Chauhan

Rather

Samarah

et al. 2022

Cells

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Diabetic macular edema (DME) is a major ocular complication of diabetes mellitus (DM), leading to significant visual impairment. DME’s pathogenesis is multifactorial. Focal edema tends to occur when primary metabolic abnormalities lead to a persistent hyperglycemic state, causing the development of microaneurysms, often with extravascular lipoprotein in a circinate pattern around the focal leakage. On the other hand, diffusion edema is due to a generalized breakdown of the inner blood–retinal barrier, leading to profuse early leakage from the entire capillary bed of the posterior pole with the subsequent extravasation of fluid into the extracellular space. The pathogenesis of DME occurs through the interaction of multiple molecular mediators, including the overexpression of several growth factors, including vascular endothelial growth factor (VEGF), insulin-like growth factor-1, angiopoietin-1, and -2, stromal-derived factor-1, fibroblast growth factor-2, and tumor necrosis factor. Synergistically, these growth factors mediate angiogenesis, protease production, endothelial cell proliferation, and migration. Treatment for DME generally involves primary management of DM, laser photocoagulation, and pharmacotherapeutics targeting mediators, namely, the anti-VEGF pathway. The emergence of anti-VEGF therapies has resulted in significant clinical improvements compared to laser therapy alone. However, multiple factors influencing the visual outcome after anti-VEGF treatment and the presence of anti-VEGF non-responders have necessitated the development of new pharmacotherapies. In this review, we explore the pathophysiology of DME and current management strategies. In addition, we provide a comprehensive analysis of emerging therapeutic approaches to the treatment of DME.

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“…The SFCT increases 1 week after PRP (55), since damage to the peripheral choriocapillaris causes peripheral choroidal blood flow to decrease and redistributes the blood flowing from the peripheral to foveal Centralia (58). However, SFCT also decreases at one (55,56) and 3 months (55,59) after PRP because of the reduction in total choroidal capillary blood flow. Although, we have excluded patients who received focal treatment for DR in the last 3 months, a potential bias may remain especially in sNPDR and PDR.…”

Section: Wmd (95% Ci) Imentioning

confidence: 99%

Optical coherence tomography evaluation of choroidal structure changes in diabetic retinopathy patients: A systematic review and meta-analysis

Jiang

Liu²,

Jia³

et al. 2022

Front. Med.

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IntroductionDiabetic retinopathy (DR) is one of the major causes of blindness among working-aged adults worldwide. This study aimed to evaluate the differences in the subfoveal choroidal thickness (SFCT) and choroidal vascularity index (CVI) using optical coherence tomography (OCT) of patients with diabetic eyes with no retinopathy (NDR) and with diabetic retinopathy (DR).MethodsWe performed a comprehensive literature search of the PubMed, Embase, and Cochrane Library databases up to October 2021. The weighted mean difference (WMD) with the 95% confidence interval (CI) was pooled for continuous outcomes.ResultsTwenty-three cross-sectional studies comprising 2,534 eyes including 1,070 NDR eyes, 1,464 DR eyes were included in the systematic review and meta-analysis. The pooled results showed SFCT was significantly thicker in DR than in NDR patients after adjusting for axial length (WMD = 27.90 μm; 95% CI: 11.51 to 44.28; P = 0.001), and the CVI was significantly lower in DR patients (WMD = −1.59; 95% CI: −2.67 to −0.52; P = 0.004).ConclusionWe described changes in the SFCT and CVI in DR. Resultantly, the CVI and SFCT may be valuable parameters for monitoring the onset of DR and helpful for a better understanding of the role of the choroid in the pathological process of DR.Systematic review registrationhttps://www.crd.york.ac.uk/prospero/#myprospero, CRD42021228738.

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Longitudinal analysis of subfoveal choroidal thickness after panretinal laser photocoagulation in diabetic retinopathy using swept-source optical coherence tomography

Cited by 6 publications

References 23 publications

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

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

Current and Novel Therapeutic Approaches for Treatment of Diabetic Macular Edema

Optical coherence tomography evaluation of choroidal structure changes in diabetic retinopathy patients: A systematic review and meta-analysis

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