Peripapillary RNFL Thickness Changes after Panretinal Photocoagulation

Optom Vis Sci. 2016 Sep;93(9):1158-62. doi: 10.1097/OPX.0000000000000885.

Abstract

Purpose: To evaluate changes in peripapillary retinal nerve fiber layer (RNFL) thickness as determined by spectral domain optical coherence tomography (SD-OCT) after panretinal photocoagulation (PRP) for proliferative diabetic retinopathy (PDR).

Methods: Forty-two eyes of 42 diabetic patients who were scheduled for PRP were enrolled in this interventional case series. Peripapillary RNFL thickness was measured using SD-OCT (OCT 1000; Topcon Co., Tokyo, Japan) at baseline and 1, 3, and 6 months after PRP.

Results: Mean global RNFL thickness was increased significantly by 3 μm (p = 0.04) 1 month after PRP and was then decreased marginally significantly by 2.4 μm at 6 months (p = 0.054) as compared to baseline values. After 1 month, RNFL thickness was increased in all quadrants, but only changes in the temporal quadrant were significant (p = 0.009). At 6 months, progressive RNFL thinning occurred in all quadrants; however, only changes in the superior quadrant were significant (p = 0.041). Visual acuity was improved by an average of 0.02 logMAR after 6 months, but this change was not statistically significant.

Conclusions: Shortly after PRP, RNFL thickness (as determined by SD-OCT) increases, but a decrease in RNFL thickness occurs at 6 months post-PRP. RNFL thickness changes based on OCT should be interpreted with caution in diabetic eyes undergoing PRP.

MeSH terms

  • Diabetic Retinopathy / diagnosis
  • Diabetic Retinopathy / surgery*
  • Female
  • Follow-Up Studies
  • Humans
  • Laser Coagulation / methods*
  • Male
  • Middle Aged
  • Nerve Fibers / pathology*
  • Optic Disk / pathology
  • Retina / pathology
  • Retina / surgery
  • Retinal Ganglion Cells / pathology*
  • Time Factors
  • Tomography, Optical Coherence / methods*
  • Visual Acuity*