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Tsuneaki Omae, Taiji Nagaoka, Akitoshi Yoshida; Retinal reperfusion following panretinal photocoagulation for diabetic retinopathy. Invest. Ophthalmol. Vis. Sci. 2014;55(13):3899.
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It has reported that reperfusion after pan retinal photocoagulation (PRP) occurred in some eyes with retinal nonperfusion area (NPA) of diabetic retinopathy. However, the contribution of reperfusion to progression of diabetic retinopathy remains unclear. The purpose of this study was to examine the incidence and impact of retinal reperfusion following PRP for proliferative diabetic retinopathy (PDR) using fluorescein angiograms (FA)
This study included 37 patients (54 eyes) with early PDR presenting with extensive range of retinal NPA in fluorescein angiographic findings and who was received PRP in our hospital between March 2008 and May 2013 with a minimum follow-up of 6 months. Their ages ranged from 35 to 77, average 58 years. FA was performed before and 2 months after PRP for evaluation of the reperfusion in retinal areas. The eyes were divided into 2 groups on the basis of the presence and absence of reperfusion and further the eyes of each group were evaluated regarding incidence of vitreous hemorrhage (VH) required vitrectomy. The eyes with residual NPA after PRP were also divided into two groups according to region where the residual NPA of retina was observed: posterior pole and midperiphery of the retina. The eyes of each group were evaluated regarding incidence of VH required vitrectomy.
After PRP, reperfusion was observed in 18 eyes (Reperfusion-group) and no reperfusion was observed in 36 eyes (No-Reperfusion group). In the No-Reperfusion group, 7 of 36 eyes (19%) was required vitrectomy due to VH, whereas no eye was required vitrectomy in the Reperfusion group (p=0.045). Among 36 eyes in No-Reperfusion group, 8 eyes showed NPA at the posterior pole (P group) and 28 eyes showed at the midperiphrey (M group). Vitrectomy was required due to VH in 2 eyes in P group and 5 eyes in M group (p=0.65).
In patients with early proliferative diabetic retinopathy, the incidence of VH required vitrectomy was higher in eyes with no reperfusion in NPA after PRP.
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