Korean J Ophthalmol.  2017 Dec;31(6):497-507. 10.3341/kjo.2016.0108.

Changes in Macular Retinal Layers and Peripapillary Nerve Fiber Layer Thickness after 577-nm Pattern Scanning Laser in Patients with Diabetic Retinopathy

Affiliations
  • 1Department of Ophthalmology, Konyang University College of Medicine, Daejeon, Korea. Astrix001@gmail.com

Abstract

PURPOSE
The aim of this study was to evaluate the changes in thickness of each macular retinal layer, the peripapillary retinal nerve fiber layer (RNFL), and central macular thickness (CMT) after 577-nm pattern scanning laser (PASCAL) photocoagulation in patients with diabetic retinopathy.
METHODS
This retrospective study included 33 eyes with diabetic retinopathy that underwent 577-nm PASCAL photocoagulation. Each retinal layer thickness, peripapillary RNFL thickness, and CMT were measured by spectral-domain optical coherence tomography before 577-nm PASCAL photocoagulation, as well as at 1, 6, and 12 months after 577-nm PASCAL photocoagulation. Computerized intraretinal segmentation of optical coherence tomography was performed to identify the thickness of each retinal layer.
RESULTS
The average thickness of the RNFL, ganglion cell layer, inner plexiform layer, inner nuclear layer, inner retinal layer, and CMT at each follow-up increased significantly from baseline (p < 0.001), whereas that of the retinal pigment epithelium at each follow-up decreased significantly from baseline (p < 0.001). The average thickness of the peripapillary RNFL increased significantly at one month (p < 0.001). This thickness subsequently recovered to 7.48 µm, and there were no significant changes at six or 12 months compared to baseline (p > 0.05).
CONCLUSIONS
Each macular retinal layer and CMT had a tendency to increase for one year after 577-nm PASCAL photocoagulation, whereas the average thickness of retinal pigment epithelium decreased at one-year follow-up compared to the baseline. Although an increase in peripapillary RNFL thickness was observed one month after 577-nm PASCAL photocoagulation, there were no significant changes at the one-year follow-up compared to the baseline.

Keyword

Diabetic retinopathy; Macular retinal layer thickness; Pattern scanning laser photocoagulation; Retinal nerve fiber layer thickness

MeSH Terms

Diabetic Retinopathy*
Follow-Up Studies
Ganglion Cysts
Humans
Light Coagulation
Nerve Fibers*
Retinal Pigment Epithelium
Retinaldehyde*
Retrospective Studies
Tomography, Optical Coherence
Retinaldehyde

Figure

  • Fig. 1 (A) Optical coherence tomography shows nine regions of the ETDRS (Early Treatment Diabetic Retinopathy Study) map. All scans produce maps of concentric circles with diameters of 1, 3, and 6 mm. (B) Optical coherence tomography shows the peripapillary retinal nerve fiber layer thickness. Consecutive circular B-scans measure global thickness and sector thickness (superonasal, nasal, inferonasal, inferotemporal, temporal, and superotemporal). TMP = temporal; SUP = superior; NAS = nasal; INF = inferior; T = temporal; TI = temporoinferior; NI = nassoinferior; N = nasal; NS = naso superior; TS = temporosuperior; G = global.

  • Fig. 2 Representation of the retinal layer division determined by the new segmentation application from the Spectralis optical coherence tomography (Segmentation Technology; Heidelberg Engineering, Heidelberg, Germany ). 10 layers: 1 = inner limiting membrane, 2 = retinal nerve fiber layer, 3 = ganglion cell layer, 4 = inner plexiform layer, 5 = inner nuclear layer, 6 = outer plexiform layer, 7 = external limiting membrane, 8 = photoreceptor, 9 = retinal pigment epithelium, 10 = Bruch's membrane.

  • Fig. 3 Longitudinal changes in the average thickness of each macular retinal layer after 577-nm pattern scanning laser (PASCAL) photocoagulation. (A) The average thickness of the retinal nerve fber layer (RNFL), ganglion cell layer (GCL), inner plexiform layer (IPL) and inner nuclear layer (INL) changed signifcantly at 12 months after 577-nm PASCAL photocoagulation compared to baseline, whereas outer plexiform layer (OPL) showed no signifcant change. (B) The average thickness of the outer nuclear layer (ONL) and the photoreceptor layer showed no signifcant changes at 12 months after 577-nm PASCAL photocoagulation compared to the baseline. (C,D) The average thickness of the inner retinal layer (IRL) and retinal pigment epithelium (RPE) changed signifcantly at 12 months after 577-nm PASCAL photocoagulation compared to baseline. *p < 0.05, **p < 0.001.

  • Fig. 4 Longitudinal changes in the average peripapillary retinal nerve fiber layer (RNFL) thickness and central macular thickness (CMT) after 577-nm pattern scanning laser photocoagulation. (A) There were no significant changes in the peripapillary RNFL thickness at 12 months post-577-nm pattern scanning laser photocoagulation compared to the baseline. (B) There were significant increases in the CMT from baseline at each follow-up. **p < 0.001.


Cited by  1 articles

Long-term Changes in the Peripapillary RNFL and Macular GCIPL Thicknesses after Panretinal Photocoagulation in Diabetic Retinopathy Patients
Jung Hyun Yoon, Dong Ho Park, Dai Woo Kim
J Korean Ophthalmol Soc. 2018;59(10):938-945.    doi: 10.3341/jkos.2018.59.10.938.


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