J Korean Ophthalmol Soc.  2009 May;50(5):717-724. 10.3341/jkos.2009.50.5.717.

Macular Thickness and Visual Acuity Before and After Panretinal Photocoagulation in Severe Diabetic Retinopathy

• Park SH
• Song SJ

• KMID: 2212306
• DOI: http://doi.org/10.3341/jkos.2009.50.5.717

Abstract

PURPOSE:To compare macular thickness and visual acuity before and after panretinal photocoagulation in patients with severe diabetic retinopathy without diabetic macular edema.
METHODS
Macular thickness and visual acuity (LogMAR) of 40 eyes were compared before and after panretinal photocoagulation, for severe diabetic retinopathy. Macular thickness was measured by optical coherence tomography(OCT). In addition, changes in macular thickness and visual acuity were compared with the patient's level of HbA1c, blood pressure, and diabetic nephropathy.
RESULTS
Mean visual acuity before and 1.47+/-0.80 months after panretinal photocoagulation were 0.28+/-0.23 and 0.33+/-0.27, respectively, which was not a significant decrease (p=0.131). However mean central macular thickness (216.98+/-34.09 microm to 255.22+/-73.40 microm), and mean peripheral macular thickness (269.26+/-34.59 microm to 291.96+/-46.49 microm) did increase significantly after panretinal photocoagulation (p=0.001). The decrease of mean visual acuity and increase of mean macular thickness were greater in patients with high blood glucose, high blood pressure and diabetic nephropathy.
CONCLUSIONS
In eyes with severe diabetic retinopathy treated with panretinal photocoagulation, mean visual acuity did not decrease significantly, but mean central and peripheral macular thickness significantly increased after treatment. We posit that visual prognosis after panretinal photocoagulation in eyes with severe diabetic retinopathy without macular edema is influenced by the control of blood glucose and blood pressure and the presence of diabetic nephropathy.

Keyword

Diabetic Retinopathy; Macular Edema; Optical Coherence Tomography (OCT); PanRetinal Photocoagulation (PRP); Visual Acuity

MeSH Terms

Blood Glucose
Blood Pressure
Diabetic Nephropathies
Diabetic Retinopathy
Eye
Humans
Hypertension
Light Coagulation
Macular Edema
Prognosis
Visual Acuity
Blood Glucose

Figure

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  Figure 1. Alteration of visual acuity. Two eyes (A) showed increase of visual acuity. Most eyes (29 eyes, B) maintained their visual acuity during the experimental period, and 9 eyes (C) showed decrease of visual acuity in this clinical course of 18 weeks.

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  Figure 2. Alterations of macular thickness before and 1.47 months after the last panretinal photocoagulation (PRP). Macular thickness of 2 eyes (A), which showed increase of visual acuity, decreased after PRP. Macular thickness of 29 eyes (B), which maintained their visual acuity during the experimental period, increased after PRP. Macular thickness of 9 eyes (C), which showed decrease of visual acuity, increased more than that of B after PRP.

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  Figure 3. Alterations of macular thickness before and after panretinal photocoagulation (PRP). Central and peripheral macular thickness increased 1.47 and 8 months after PRP.

Reference

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