March 2012
Volume 53, Issue 14
Free
ARVO Annual Meeting Abstract  |   March 2012
Spatial Patterns of Central Visual Field Loss in Proliferative Diabetic Retinopathy and Related Changes after Optos®-guided Pascal® Laser Treatment
Author Affiliations & Notes
  • Yanfang Wang
    Faculty of Med & Human Sciences, The University of Manchester, Manchester, United Kingdom
  • Mahiul M K Muqit
    Faculty of Med & Human Sciences, The University of Manchester, Manchester, United Kingdom
    Manchester Royal Eye Hospital, Manchester, United Kingdom
  • Paulo E. Stanga
    Faculty of Med & Human Sciences, The University of Manchester, Manchester, United Kingdom
    Manchester Royal Eye Hospital, Manchester, United Kingdom
  • Lorna B. Young
    Manchester Royal Eye Hospital, Manchester, United Kingdom
  • David B. Henson
    Faculty of Med & Human Sciences, The University of Manchester, Manchester, United Kingdom
  • Footnotes
    Commercial Relationships  Yanfang Wang, None; Mahiul M K Muqit, None; Paulo E. Stanga, Optimedica (I), Optos, Topcon (C, R); Lorna B. Young, None; David B. Henson, None
  • Footnotes
    Support  None
Investigative Ophthalmology & Visual Science March 2012, Vol.53, 2861. doi:
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    • Get Citation

      Yanfang Wang, Mahiul M K Muqit, Paulo E. Stanga, Lorna B. Young, David B. Henson; Spatial Patterns of Central Visual Field Loss in Proliferative Diabetic Retinopathy and Related Changes after Optos®-guided Pascal® Laser Treatment. Invest. Ophthalmol. Vis. Sci. 2012;53(14):2861.

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

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Abstract

Purpose: : To explore the spatial distribution of functional loss and the effect of Optos® -guided PASCAL® laser therapy on central visual field (VF) in untreated proliferative diabetic retinopathy (PDR).

Methods: : VF data (SITA 24-2) from 99 eyes (66 patients) with treatment-naive PDR were used to train a self-organizing map (SOM) and classified the defects into 9 patterns. 28 eyes of 23 patients treated with 20-millisecond PASCAL®retinal laser photocoagulation underwent OPTOS® widefield fundus fluorescein angiography (WF-FFA) at baseline and 3-months post treatment. Pre- and post-treatment changes of VF (SOM patterns, Mean Deviation (MD) and Pattern Standard Deviation (PSD)) were compared. Improvements of VF defect (Total Deviation, TD) at different eccentricities (0-10, 10-20 20-30 degrees) were also investigated and correlated with the extent of initial loss. Grading of WF-FFA post-laser was undertaken by 2 masked retina specialists.

Results: : At baseline 44.4% of PDR eyes showed early VF loss patterns (1 to 3) with 23.2% classified into the advanced patterns (7 to 9). Mild SOM patterns had more superior hemifield VF defects while advanced patterns involved both superior and inferior hemifield VF loss. Following laser a significant shift to early SOM patterns were observed (p=0.02), as well as improvement of MD and PSD (p=0.003 and 0.06 respectively). Improvement of TD was observed commonly in test locations of 0-10, 10-20 and 20-30 degrees (39.3%, 60.7%, 64.3% separately) and the differences between three zones was not significant (p=0.35). Greater improvement was observed with deeper baseline TD (p<0.001). Masked, WF-FFA image grading showed 78.6% PDR regression.

Conclusions: : The SOM method is a promising technique to classify and monitor over time PDR-associated VF defects. Optos® -guided PASCAL® 20-millisecond retinal laser treatment improved the spatial patterns and global parameters of central VF defects.

Keywords: diabetic retinopathy • visual fields • laser 
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