September 2016
Volume 57, Issue 12
Open Access
ARVO Annual Meeting Abstract  |   September 2016
Improvement in retinal venous oxygen saturation after panretinal photocoagulation is predictive of progression of proliferative diabetic retinopathy
Author Affiliations & Notes
  • Thomas Lee Torp
    Ophthalmology, Odense University Hospital, Odense, Fyn, Denmark
    The Clinical Research Institute, University of Southern Denmark, Odense, Fyn, Denmark
  • Ryo Kawasaki
    The Department of Public Health, Yamagata University Faculty of Medicine, Yamagata, Japan
  • Tien Yin Wong
    General Chataract and Comprehenvise Ophthalmology, Singapore National Eye Center, Singapore, Singapore
  • Tunde Peto
    The NIHR Biomedical Research Centre, Moorfields Eye Hospital NHS Foundation Trust and UCL institute of Ophthalmology, London, United Kingdom
    The Clinical Research Institute, University of Southern Denmark, Odense, Fyn, Denmark
  • Jakob Grauslund
    Ophthalmology, Odense University Hospital, Odense, Fyn, Denmark
    The Clinical Research Institute, University of Southern Denmark, Odense, Fyn, Denmark
  • Footnotes
    Commercial Relationships   Thomas Torp, None; Ryo Kawasaki, None; Tien Wong, None; Tunde Peto, OPTOS (F); Jakob Grauslund, None
  • Footnotes
    Support  Velux Foundation, The Region of Souther Denmark PHD FUND.
Investigative Ophthalmology & Visual Science September 2016, Vol.57, 6356. doi:
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      Thomas Lee Torp, Ryo Kawasaki, Tien Yin Wong, Tunde Peto, Jakob Grauslund; Improvement in retinal venous oxygen saturation after panretinal photocoagulation is predictive of progression of proliferative diabetic retinopathy. Invest. Ophthalmol. Vis. Sci. 2016;57(12):6356.

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      © ARVO (1962-2015); The Authors (2016-present)

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Abstract

Purpose : We performed a prospective, interventional clinical study on patients with proliferative diabetic retinopathy (PDR) in order to investigate changes in retinal oximetry before and three months after panretinal photocoagulation (PRP) and to correlate this to PDR-activity.

Methods : Thirty-nine eyes from 34 patients with diagnosed PDR were included. We performed wide-field fluorescein angiography (WFA) (Optomap; Optos PLC., Dunfermline, Scotland, UK) and retinal oximetry (Oxymap model T1; Oxymap, software version 2.4.2, Reykjavik, Iceland) at baseline and three months after PRP by a navigated laser (NAVILAS®; OD-OS GmbH, Berlin, Germany). At follow-up, WFA was used to evaluate PDR activity and patients were categorized into two groups: progression (Group 1, n=10) or stability/regression of PDR (Group 2, n=29).
Retinal oximetry measurements were performed on optic disc centered images using the in-built software that automatically marked the vessels; one larger arteriole and venule in each quadrant were identified for measurements, pre-specified protocol.

Results : At baseline, mean age and duration of diabetes were 54.8± years and 21.7± years, respectively, and 72% were male. HbA1c was 67±mmol/mol, and the mean blood pressure was 152/84mmHg. Retinal arterial and venous saturation was 96.7% and 67.4%, respectively.
Patients in Group 1 and 2 did not differ in baseline retinal arterial and venous oxygen saturation, number of laser spots delivered, total laser energy delivered, or change in retinal arterial oxygen saturation after PRP (-1.2% vs. -0.4%, p=0.92).
In contrast, as compared to baseline, the improvement in retinal vein oxygen saturation was significantly different between the groups (+2.7% for Group 1 vs. -3.5% for Group 2, p=0.02).
In a multivariable logistic regression analysis, adjusted for the mentioned variables, the change in retinal vein oxygen saturation between baseline and follow-up independently predicted PDR-progression (OR 1.31 per 1% increment in retinal venous oxygen saturation between baseline and follow-up, 95% CI 1.03-1.61, p=0.03).

Conclusions : Lack of reduction in retinal venous oxygen saturation after PRP was independently associated with PDR-activity. This might reflect absence in reduction in vascular endothelial growth factor (VEGF) and could be a potential non-invasive marker of disease activity.

This is an abstract that was submitted for the 2016 ARVO Annual Meeting, held in Seattle, Wash., May 1-5, 2016.

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