Peripapillary Retinal Nerve Fiber Layer Thickness Change After Panretinal Photocoagulation in Patients With Diabetic Retinopathy

Kim, Ho Young; Cho, Ho Kyun

doi:10.3341/kjo.2009.23.1.23

Cited by 39 publications

(39 citation statements)

References 9 publications

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“…Unlike this, no significant reductions in nerve fibre layer thickness were observed at 6 months in non-proliferative DR without laser treatment. 20 Diabetic patients may have sub-clinical, underlying visual field defects secondary to pre-existing severe non-proliferative DR or PDR. 22 Laser treatment for PDR induces visual field defects as the ETDRS reported significant worsening and constriction of the visual field at 4 months after full, scatter PRP.…”

Section: Discussionmentioning

confidence: 99%

Effects of conventional argon panretinal laser photocoagulation on retinal nerve fibre layer and driving visual fields in diabetic retinopathy

Muqit

Wakely

Stanga

et al. 2009

Eye

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Section: Discussionmentioning

confidence: 99%

Effects of conventional argon panretinal laser photocoagulation on retinal nerve fibre layer and driving visual fields in diabetic retinopathy

Muqit

Wakely

Stanga

et al. 2009

Eye

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“…Transient thickening post-PRP with the conventional argon laser has also been described by many authors (Kim & Cho 2009). However, the effect of PASCAL on peripapillary RNFL thickness has not been well described.…”

Section: Introductionmentioning

confidence: 84%

“…High powered lasers cause transmission of heat to adjacent tissue causing destructive effects and inflammatory response immediately after laser treatment. This transmitted effect predisposes patients not only to macular edema due to transient choroidal thickening, but, in the long run, increases the risk of developing epiretinal membranes (Kim & Cho 2009). Moreover, the end point laser marks tend to exaggerate with time, which correlates well with reported histological data (Maeshima et al 2004).…”

Section: Discussionmentioning

confidence: 99%

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Retinal Nerve Fiber Layer Thickness Post-Laser Treatment in Diabetic Retinopathy: Argon versus Pattern Scanning Laser

Maimunah¹,

Rahman²,

Othman³

et al. 2016

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ABSTRAK Rawatan konvensional laser argon menyebabkan ketebalan sementara pada lapisan saraf retina (RNFL). Tetapi kesan dari 'pattern scanning laser' (PASCAL) tidak banyak diketahui. Kajian ini dilakukan untuk membandingkan kesan selepas konvensional laser argon dibandingkan dengan & Health 2016;11(2): 199-208 Maimunah M. et al. The principle by which the laser exerts its therapeutic effects relies on the destruction of the outer retina. This reduces the oxygen demand while maintaining a constant oxygen input. Laser burns may also serve as physiological windows through which oxygen diffuses from the choroid, increasing vitreous oxygenation and induced vasoconstriction (VelezMontota et al. 2010). However, despite the efficacy for preventing severe visual loss, laser PRP is often associated with substantial ocular side effects, such as ABSTRACT Conventional argon laser causes transient thickening of retinal nerve fibre layer (RNFL). The effect of pattern scanning laser (PASCAL) has not been well described. We compared the immediate changes in peripapillary RNFL thickness post-panretinal photocoagulation between conventional argon lasers and PASCAL in patients with diabetic retinopathy changes. A total of 32 subjects were recruited. There were 16 patients in the argon group and 16 patients in PASCAL group. Diabetic patients were recruited from Ophthalmology Clinic, Universiti Kebangsaan Malaysia Medical Centre (UKMMC). Complete eye examinations and fundus photographs were performed at baseline prior to laser treatment, and post-laser treatment at two and four months. RNFL thickness was measured using time domain optical coherence tomography. Both groups were comparable with respect to clinical characteristics and demographics. There was no significant difference in average RNFL thickness between the two groups prior to treatment (p= 0.323). RNFL post-laser treatment for patients receiving conventional argon laser remained unchanged with no significant differences in all quadrants at any time-point (two and four months). However, for the PASCAL group, significant thickening occurred at four months for average RNFL and the inferior quadrant (p <0.05). The other quadrants similarly demonstrated increasing thickness at four months but this did not reach statistical significance. Transient RNFL thickening occurs in both conventional and PASCAL laser patients. The PASCAL laser induces a greater increase in RNFL thickness than the argon laser group. Important events, such as laser eye treatments and even type of laser used, are worthy of consideration when evaluating RNFL.

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“…Likewise, ONHs in eyes treated with PRP are more likely to be graded as abnormal, but their appearance is not necessarily glaucomatous and may be related to thinning of the RNFL [10]. In contrast, Kim et al concluded that there was no detectable change to the optic nerve following PRP [18].…”

Section: Introductionmentioning

confidence: 90%

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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Peripapillary Retinal Nerve Fiber Layer Thickness Change After Panretinal Photocoagulation in Patients With Diabetic Retinopathy

Cited by 39 publications

References 9 publications

Effects of conventional argon panretinal laser photocoagulation on retinal nerve fibre layer and driving visual fields in diabetic retinopathy

Effects of conventional argon panretinal laser photocoagulation on retinal nerve fibre layer and driving visual fields in diabetic retinopathy

Retinal Nerve Fiber Layer Thickness Post-Laser Treatment in Diabetic Retinopathy: Argon versus Pattern Scanning Laser

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

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