J Korean Ophthalmol Soc.  2018 Oct;59(10):938-945. 10.3341/jkos.2018.59.10.938.

Long-term Changes in the Peripapillary RNFL and Macular GCIPL Thicknesses after Panretinal Photocoagulation in Diabetic Retinopathy Patients

Affiliations
  • 1Department of Ophthalmology, School of Medicine, Kyungpook National University, Daegu, Korea. proector97@gmail.com
  • 2Department of Ophthalmology, Kyungpook National University Hospital, Daegu, Korea.

Abstract

PURPOSE
To investigate longitudinal changes in the thicknesses of the peripapillary retinal nerve fiber layer (pRNFL) and the macular ganglion cell-inner plexiform layer (mGCIPL) in patients with diabetic retinopathy 3 years after panretinal photocoagulation (PRP).
METHODS
We retrospectively reviewed the medical records of 60 eyes of 35 patients who were diagnosed with diabetic retinopathy and treated with PRP. The pRNFL and mGCIPL thicknesses were measured by optical coherence tomography at baseline, and then at 1, 3, 6, 9, 12, 24, and 36 months after PRP.
RESULTS
The pRNFL and mGCIPL thicknesses (average and all sections) at 1 year after PRP increased significantly from baseline (p < 0.05, respectively). The average pRNFL and mGCIPL thicknesses showed a tendency to decrease continuously from 2 years after PRP (p < 0.05, respectively). There was no statistically significant difference in the average thicknesses of the pRNFL and the mGCIPL between pre-PRP (92.27 ± 7.76 µm, and 85.00 ± 4.80 µm, respectively) and 3 years after PRP (93.93 ± 7.49 µm, and 81.87 ± 14.00 µm, respectively) (p = 0.121, and p = 0.622, respectively).
CONCLUSIONS
Although the pRNFL and the mGCIPL thicknesses increased at 1 year after PRP, there was no statistical difference in the average thicknesses of the pRNFL and the mGCIPL between pre-PRP and 3 years after PRP. These results should be considered with respect to the diagnosis and progression of glaucoma in patients with diabetic retinopathy who undergo PRP.

Keyword

Diabetic retinopathy; Ganglion cell-inner plexiform layer thickness; Glaucoma; Panretinal photocoagulation; Retinal nerve fiber layer thickness

MeSH Terms

Diabetic Retinopathy*
Diagnosis
Ganglion Cysts
Glaucoma
Humans
Light Coagulation*
Medical Records
Nerve Fibers
Retinaldehyde
Retrospective Studies
Tomography, Optical Coherence
Retinaldehyde

Figure

  • Figure 1 Peripapillary retinal nerve fiber layer (RNFL) and macular ganglion cell-inner plexiform layer (GCIPL) thickness in Cirrus optical coherence tomography (OCT). (A) OCT shows the RNFL thicknesses of average and four-quadrant in both eyes. (B) OCT shows GCIPL thicknesses of average and six-sector in both eyes. OD = oculus dexter; OS = oculus sinister; GCL = ganglion cell layer; IPL = inner plexiform layer; S = superior; T = temporal; N = nasal; I = inferior; NA = non-available.

  • Figure 2 Longitudinal changes in the average and four-quadrant thicknesses (µm) of the peripapillary retinal nerve fiber layer (RNFL) after panretinal photocoagulation (PRP). The RNFL thicknesses (average and four-quadrant) increased at 1 month after PRP and had declined continuously since then (A–E). Repeated-measures analysis of variance corrected by Bonferroni method showed that the RNFL thicknessess (average and four-quadrant) increased at 1 year after PRP (all p < 0.05), but there was no statistically significant difference of the average, inferior, nasal and temporal thicknesses of the RNFL between pre-PRP and 3 years after PRP (A, C–E). The superior RNFL thickness (93.93 ± 7.49 µm) decreased at 3 years after PRP from the thickness (92.27 ± 7.76 µm) before PRP (p = 0.442) (B). *p < 0.05 by repeated-measures analysis of variance corrected by the Bonferroni methods; †p < 0.05 by paired t-test.

  • Figure 3 Longitudinal changes in the average and six-sector thicknesses (µm) of the macular ganglion cell-inner plexiform layer (GCIPL) after panretinal photocoagulation (PRP). Repeated-measures analysis of variance corrected by Bonferroni method showed that macular GCIPL thicknesses (average and 6-sector) increased in 1 year after PRP (all p < 0.05). The average GCIPL thickness showed a tendency to increase until 1 year, but to decrease continuously from 2 year after PRP. There was no statistically significant difference of the average, superior, superonasal, inferior, inferotemporal and superotemporal GCIPL thicknesses between pre-PRP and 3 years after PRP (A–C, E–G). The inferonasal GCIPL thickness (81.87 ± 19.0 µm) decreased at 3 years after PRP from the thickness (85.00 ± 4.80 µm) before PRP (p = 0.544) (D). *p < 0.05 by repeated-measures analysis of variance corrected by the Bonferroni methods; †p < 0.05 by by paired t-test.


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