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Retinal and Choroidal Alterations in Diabetic Retinopathy Treatment using Subthreshold Panretinal Photocoagulation
Zijing Li1,2, Tu Lu1, Lijun Zhou1
1State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-Sen University, 54 South Xianlie Road, Guangzhou, 510060, China.
Ophthalmology and Therapy
|April 30, 2023
Summary
Panretinal photocoagulation (PRP) using PASCAL with endpoint management (EPM) may cause less severe and delayed retinal and choroidal changes compared to conventional PASCAL in severe nonproliferative diabetic retinopathy (NPDR). EPM is a potential alternative for PRP treatment.
Area of Science:
- Ophthalmology
- Diabetic Retinopathy Treatment
- Laser Therapy
Background:
- Severe nonproliferative diabetic retinopathy (NPDR) requires effective treatment to prevent vision loss.
- Panretinal photocoagulation (PRP) is a standard treatment for severe NPDR.
- Evaluating novel laser delivery methods for PRP is crucial for optimizing patient outcomes.
Purpose of the Study:
- To compare retinal and choroidal alterations after panretinal photocoagulation (PRP) in severe nonproliferative diabetic retinopathy (NPDR).
- To assess the efficacy of conventional PASCAL versus PASCAL with endpoint management (EPM) in treating diabetic retinopathy.
- To analyze changes in retinal thickness, choroidal thickness, and choroidal vascularity index post-PRP.
Main Methods:
- A post hoc analysis of a paired randomized clinical trial involving 70 eyes of 35 patients with severe NPDR.
- Eyes were randomly allocated to receive either threshold PRP or subthreshold EPM PRP.
- Measurements included retinal thickness (RT), choroidal thickness (CT), choroidal area, and choroidal vascularity index (CVI) at multiple follow-up visits up to 12 months.
Main Results:
- Subthreshold EPM PRP showed significantly thinner retinal thickness at 3 and 6 months post-treatment compared to threshold PRP.
- Threshold PRP led to earlier reductions in choroidal thickness and stromal/luminal areas than subthreshold EPM PRP.
- Choroidal vascularity index (CVI) did not significantly differ between the groups or within groups at most time points.
Conclusions:
- PRP using PASCAL with EPM may result in less severe and delayed retinal and choroidal disturbances at 12 months post-treatment compared to conventional PASCAL.
- The EPM algorithm presents a potentially beneficial alternative for PRP in managing severe NPDR.
- Further research may explore long-term outcomes and safety profiles of EPM in diabetic retinopathy treatment.
