Korean J Ophthalmol.  2010 Feb;24(1):16-22. 10.3341/kjo.2010.24.1.16.

Diabetic Retinopathy and Peripapillary Retinal Thickness

• Cho HY
• Lee DH
• Chung SE
• Kang SW

• KMID: 1098788
• DOI: http://doi.org/10.3341/kjo.2010.24.1.16

Abstract

PURPOSE: To assess the diagnostic efficacy of macular and peripapillary retinal thickness measurements for the staging of diabetic retinopathy (DR) and the prediction of disease progression.
METHODS
In this prospective study, 149 diabetic patients (149 eyes) and 50 non-diabetic control subjects were included. Baseline optical coherence tomography was employed to measure retinal thickness in the macula (horizontal, vertical, and central) and the peripapillary zone (superior, inferior, nasal, and concentric to the optic disc). Seven baseline parameters were correlated with the DR stages identified by fluorescein angiography. Baseline retinal thickness was compared between groups of patients requiring panretinal photocoagulation (PRP) within 6 months (PRP group) and patients not requiring PRP (No-PRP group).
RESULTS
Macular and peripapillary retinal thicknesses in diabetic subjects were significantly greater than that in normal controls (p<0.05). All retinal thickness parameters, and particularly peripapillary circular scans, tended to increase with increasing DR severity (p<0.05). The baseline thicknesses of the peripapillary circular scans were greater in the PRP group than in the no-PRP group (p<0.05).
CONCLUSIONS
Peripapillary retinal thickness may prove to be a useful criterion for DR severity and may also serve as an indicator of disease progression.

Keyword

Diabetic retinopathy; Laser photocoagulation; Retina; Mass screening

MeSH Terms

Aged
Diabetic Retinopathy/*diagnosis/surgery
Disease Progression
Female
Fluorescein Angiography
Humans
Light Coagulation
Male
Middle Aged
Optic Disk
Prospective Studies
Retina/*pathology/surgery
*Severity of Illness Index
*Tomography, Optical Coherence

Figure

• 

  Fig. 1 Optic coherence tomography scans were performed at the macula and peripapillary zones, indicated by the line superimposed on the fundus photograph. Horizontal (H) and vertical (V) scans of the macula were centered through the fovea. Superior (S), inferior (I) and nasal (N) scans of the peripapillary zone originated within the one-third of disc diameter from the disc margin. All linear scans were 6 mm in length. The peripapillary circular scan (D) was obtained concentric to the optic disc, with a diameter of 6 mm.

• 

  Fig. 2 Retinal thickness (µm) in the normal population, diabetic patients without retinopathy, and four groups of diabetic patient with retinopathy. DM=diabetes; DR=diabetic retinopathy; NPDR=non-proliferative diabetic retinopathy; PDR=proliferative diabetic retinopathy; H=horizontal in macula; V=vertical in macula; S=superior to optic disc; I=inferior to optic disc; N=nasal to optic disc; D=circular concentric to optic disc; CMT=central macular thickness at foveal pit.

• 

  Fig. 3 Comparison of baseline retinal thickness of panretinal photocoagulation (PRP) (26 eyes) and No-PRP group (45 eyes). The two groups consisted of diabetic eyes with severe non-proliferative diabetic retinopathy or proliferative diabetic retinopathy. Subsequent PRP was conducted for the PRP group within the 6 month follow-up period after baseline optic coherence tomography measurements due to disease progression. Asterisks indicate significant differences between the two groups: *p<0.05. H=horizontal in macula; V=vertical in macula; S=superior to optic disc; I=inferior to optic disc; N=nasal to optic disc; D=circular concentric to optic disc; CMT=central macular thickness at fovea pit.

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