June 2017
Volume 58, Issue 8
Open Access
ARVO Annual Meeting Abstract  |   June 2017
Successful panretinal photocoagulation leads to changes in the retinal venular vascular geometry in patients with proliferative diabetic retinopathy.
Author Affiliations & Notes
  • Thomas Lee Torp
    Department of Ophthalmology, Odense University Hospital, Odense C, Denmark
    Department of Clinical Research, University of Southern Denmark, Odense, Region of Southern Denmark, Denmark
  • Anna Stage Vergmann
    Department of Ophthalmology, Odense University Hospital, Odense C, Denmark
    Department of Clinical Research, University of Southern Denmark, Odense, Region of Southern Denmark, Denmark
  • Ryo Kawasaki
    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
    Queen’s University Belfast, Belfast, United Kingdom
    Department of Clinical Research, University of Southern Denmark, Odense, Region of Southern Denmark, Denmark
  • Jakob Grauslund
    Department of Ophthalmology, Odense University Hospital, Odense C, Denmark
    Department of Clinical Research, University of Southern Denmark, Odense, Region of Southern Denmark, Denmark
  • Footnotes
    Commercial Relationships   Thomas Lee Torp, None; Anna Stage Vergmann, None; Ryo Kawasaki, None; Tien Wong, None; Tunde Peto, None; Jakob Grauslund, None
  • Footnotes
    Support  None
Investigative Ophthalmology & Visual Science June 2017, Vol.58, 67. doi:
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      Thomas Lee Torp, Anna Stage Vergmann, Ryo Kawasaki, Tien Yin Wong, Tunde Peto, Jakob Grauslund; Successful panretinal photocoagulation leads to changes in the retinal venular vascular geometry in patients with proliferative diabetic retinopathy.. Invest. Ophthalmol. Vis. Sci. 2017;58(8):67.

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

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Abstract

Purpose : Panretinal photocoagulation (PRP) is used for proliferative diabetic retinopathy (PDR), but there is a delicate balance between insufficient treatment and laser-induced side effects like visual field constriction and night blindness as caused by excessive treatment. Hence, non-invasive markers of disease activity are needed to monitor treatment outcome. We aimed to determine changes in retinal vessel geometry (tortuosity, length-diameter-ratio (LDR), branching-coefficient (BC), branching angle (BA), deviation from optimal branching coefficient (DOBC) and fractal dimension (FD)) in a prospective, interventional clinical study of patients with PDR before and three months after PRP.

Methods : Fifty-one eyes from 44 patients with PDR were included. We used wide-field fluorescein angiography (Optomap, Optos PLC., Dunfermline, Scotland, UK) to diagnose PDR at baseline and to assess activity at month 3. At baseline and follow-up, a certified grader measured retinal vessel geometry between 0.5 and 2.0 disc diameters from the optic disc by a semi-automated software (SIVA, Singapore I Vessel Assessment, National University of Singapore, Singapore) according to a standardized protocol.

Results : At baseline, mean age and duration of diabetes was 53.1 and 21.1 years, respectively, and 68.6% were male. Mean HbA1c and blood pressure were 68.1 mmol/mol and 159/85 mmHg.
Prior to PRP, mean retinal arteriolar and venular parameters were 1.119 and 1.107 (tortuosity), 16.69 and 11.77 (LDR), 1.52 and 1.32 (BC), 80.87 and 81.12 (BA), and -0.52 and -0.29 (DOBC). FD was 1.476.
At follow-up, 15 eyes had progression of PDR as opposed to 36 eyes that did not. Retinal vessel geometry did not differ between the groups at baseline, but patients with progression had higher arterial BA at follow-up (82.08 vs. 77.62, p=0.02). Likewise, between baseline and follow-up patients without progression of PDR changed in venous LDR (11.47 vs. 13.99, p=0.04), BC (1.33 vs. 1.42, p<0.01), and DOBC (-0.28 vs. -0.41, p<0.01). Both groups increased in FD (progression: 1.486 vs. 1.502, p=0.03, non-progression: 1.472 vs. 1.487, p=0.02).

Conclusions : Successful PRP leads to alterations in particular in the retinal venular vascular structure. If confirmed with longer time of observation, this may serve as a potential biomarker to determine the individualized threshold of optimal treatment.

This is an abstract that was submitted for the 2017 ARVO Annual Meeting, held in Baltimore, MD, May 7-11, 2017.

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