July 2019
Volume 60, Issue 9
Open Access
ARVO Annual Meeting Abstract  |   July 2019
Evaluation of retinal vascularization in diabetic retinopathy before and after panretinal photocoagulation using optical coherence tomography angiography
Author Affiliations & Notes
  • Guillaume LE GUERN
    Hopital Lariboisiere, Paris, France, Paris, France
  • Jennifer Marie Louise
    Hopital Lariboisiere, Paris, France, Paris, France
  • Chetrit Mardoche
    Hopital Lariboisiere, Paris, France, Paris, France
  • Valérie Mané
    Hopital Lariboisiere, Paris, France, Paris, France
  • Valérie Krivosic
    Hopital Lariboisiere, Paris, France, Paris, France
  • Elise Philippakis
    Hopital Lariboisiere, Paris, France, Paris, France
  • Alain Gaudric
    Hopital Lariboisiere, Paris, France, Paris, France
  • Aude Couturier
    Hopital Lariboisiere, Paris, France, Paris, France
  • Benedicte Dupas
    Hopital Lariboisiere, Paris, France, Paris, France
  • Ali Erginay
    Hopital Lariboisiere, Paris, France, Paris, France
  • Ramin Tadayoni
    Hopital Lariboisiere, Paris, France, Paris, France
  • Footnotes
    Commercial Relationships   Guillaume LE GUERN, None; Jennifer Marie Louise, None; Chetrit Mardoche, None; Valérie Mané, None; Valérie Krivosic, None; Elise Philippakis, None; Alain Gaudric, None; Aude Couturier, None; Benedicte Dupas, None; Ali Erginay, None; Ramin Tadayoni, None
  • Footnotes
    Support  None
Investigative Ophthalmology & Visual Science July 2019, Vol.60, 1215. doi:https://doi.org/
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      Guillaume LE GUERN, Jennifer Marie Louise, Chetrit Mardoche, Valérie Mané, Valérie Krivosic, Elise Philippakis, Alain Gaudric, Aude Couturier, Benedicte Dupas, Ali Erginay, Ramin Tadayoni; Evaluation of retinal vascularization in diabetic retinopathy before and after panretinal photocoagulation using optical coherence tomography angiography. Invest. Ophthalmol. Vis. Sci. 2019;60(9):1215. doi: https://doi.org/.

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

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Abstract

Purpose : Previous studies have shown that retinal blood flow is reduced after panretinal photocoagulation (PRP) for diabetic retinopathy using laser speckle flowgraphy. The purpose of our study was to describe modifications of retinal vascularization on optical coherence tomography angiography (OCT A) after PRP for diabetic retinopathy.

Methods : This prospective observational longitudinal clinical study included 35 eyes of 24 patients with severe nonproliferative diabetic retinopathy (n=17) or proliferative diabetic retinopathy (n=18). Exclusion criteria were macular edema, media opacities, and prior PRP. Macular vascular density was measured on 6x6mm scans, and peripapillary vascular density was measured on 4.5x4.5mm scans using OCT A (Optovue Inc, Fremont, California) at baseline, after 3 PRP sessions (M2), and 3 months after PRP (M5). Peripheral vascularization was assessed by automated reconstruction of five 9x9mm scans (PLEX Elite 9000 Swept Source OCT, Zeiss, Dublin, California) at M0 and M5.

Results : The mean whole image macular vascular density did not significantly change during the follow-up period compared to baseline (M0: 45.58%±0.60; M2: 44.48%±0.67; M5: 45.26%±0.57 for superficial vascular complex ; p=0.99 and 0.98; and M0: 45.39%±0.73; M2: 44.63%±1.28; M5: 45.49%±0.86 for deep capillary plexus; p=0.99 and 0.98). Mean global RNFL thickness was significantly increased at M2 but did not differ from baseline at M5 (M0: 111.0µm±2.4; M2:119.4µm±2.1; M5: 110.3µm±3; p=0.01 and p=0.91). Peripapillary vascular density was decreased at M2 but not at M5 in nasal superior (M0 : 45.1%±0.9; M2: 42.7%±1.2; M5: 45.2%±0.1, p<0.01 and p=0.98), superotemporal (M0: 51.0%±0.8; M2: 48.57%±1.5; M5: 50.5%±1.0; p<0.01 and p=0.93), and inferonasal quadrant (M0:47.7%±1.0; M2: 44.8%±1.6; M5: 45.17%±1.2; p<0.01 and p=0.72). Ten eyes had neovessels elsewhere or on the disc at baseline. After PRP, neovessels morphology showed pruning in 5 cases, and worsening of preexisting vitreoretinal tractions in 3 cases.

Conclusions : Macular vascular density does not change after PRP. A transient elevation of RNFL thickness is associated with a reduction of peripapillary vascular density. Wide-Field OCT A is useful to follow morphologic changes of neovessels after PRP.

This abstract was presented at the 2019 ARVO Annual Meeting, held in Vancouver, Canada, April 28 - May 2, 2019.

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