EVALUATION OF CHOROIDAL THICKNESS IN HIGH-RISK PROLIFERATIVE DIABETIC RETINOPATHY TREATED WITH PANRETINAL PHOTOCOAGULATION ASSOCIATED OR NOT WITH INTRAVITREAL BEVACIZUMAB INJECTIONS: A 3 MONTHS, RANDOMIZED, CONTROLLED AND MASKED CLINICAL TRIAL

Abstract

Purpose: To evaluated the macular choroidal thickness after panretinal photocoagulation (PRP) combined with intravitreal Bevacizumab (IVB) injections in the treatment of high-risk proliferative diabetic retinopathy (PDR).

Methods: Prospective, controlled, randomized, masked study conducted with 23 patients with high-risk PDR. Both eyes of the same patient were randomized. One eye was treated with only PRP (control group) and the fellow eye with both PRP and 1.25 mg/0.05 ml of IVB injections (study group). The spectral-domain optical coherence tomography with enhanced depth imaging (EDI) was used to measure choroidal thickness. Choroidal thickness was measured from the posterior edge of the retinal pigment epithelium to the choroid/sclera junction at 500-μm intervals up to 2,500 μm temporal and nasal to the fovea. The data were recorded immediately and at 1 and 3 months follow-up visit

Results: In the study, 23 patients were included and 7 (30.43%) had unreliable measures at least in one eye. The mean age of the 23 patients (46 eyes) was 52.2 years (standard deviation, 9.16 years), and 14 patients (60.86%) were male. The choroid was thickest underneath the fovea (mean, 341.64 μm; standard deviation, 74.19 μm) and (mean, 339.93 μm; standard deviation, 72.22 μm) in the study and control group, respectively. Comparing groups there was no statistically significant difference in macular choroidal thickness changes after treatment throughout the follow-up period. The study group had increased the macular choroidal thickness significantly at 1 (P=.002) month of follow-up and there was no statistical significancy in the control group in all follow-up period.

Conclusions: Despite the absence of statistically significant difference in macular choroidal thickness changes between groups, probably due to the small sample size, IVB injections associated with PRP seems to increase the macular choroidal thickness in a short period of follow-up and this could be beneficial.

Keywords: 452 choroid • 499 diabetic retinopathy • 552 imaging methods (CT, FA, ICG, MRI, OCT, RTA, SLO, ultrasound)