Huang Tian, Li Xiaoli, Xie Jie, Zhang Liang, Zhang Guanrong, Zhang Aiping, Chen Xiangting, Cui Ying, Meng Qianli
Department of Ophthalmology, Guangdong Provincial People's Hospital, Guangdong Eye Institute, The Second School of Clinical Medicine, Southern Medical University, Guangdong Academy of Medical Sciences, Guangzhou, China.
State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, China.
Front Med (Lausanne). 2021 Oct 18;8:752538. doi: 10.3389/fmed.2021.752538. eCollection 2021.
To evaluate the long-term retinal microvascular, neural, and choroidal changes in the patients with severe nonproliferative diabetic retinopathy (NPDR) and proliferative diabetic retinopathy (PDR) following panretinal photocoagulation (PRP). Forty-five eyes of 28 patients with treatment-naive severe NPDR and PDR were included and followed for 12 months after PRP. Microvascular and neural changes in the macular and peripapillary areas were assessed by using optical coherence tomography angiography. Subfoveal choroidal thickness (SFCT) was measured by using optical coherence tomography. A Linear mixed-effects model was used to highlight the differences for the variables after adjusting for sex, age, and axial length. Compared to baseline, there were no statistical differences in the best corrected visual acuity (BCVA), macular and peripapillary vessel density (VD), and SFCT following PRP. Macular thickness significantly increased at 1 and 3-6 months after PRP ( < 0.05), while the peripapillary retinal nerve fiber layer (RNFL) and ganglion cell complex (GCC) thickness significantly increased at 1 month postoperatively ( < 0.01). Global loss volume and focal loss volume significantly decreased at the same time point ( < 0.05). The unchanged BCVA, VD, the thickness of RNFL and GCC, and SFCT during the 12-month follow-up period suggest that PRP may prevent the retinal neurovascular and choroidal damage.
评估全视网膜光凝(PRP)后重度非增殖性糖尿病视网膜病变(NPDR)和增殖性糖尿病视网膜病变(PDR)患者的长期视网膜微血管、神经和脉络膜变化。纳入28例初治重度NPDR和PDR患者的45只眼,在PRP后随访12个月。使用光学相干断层扫描血管造影评估黄斑和视乳头周围区域的微血管和神经变化。使用光学相干断层扫描测量黄斑下脉络膜厚度(SFCT)。采用线性混合效应模型,在调整性别、年龄和眼轴长度后突出变量之间的差异。与基线相比,PRP后最佳矫正视力(BCVA)、黄斑和视乳头周围血管密度(VD)以及SFCT无统计学差异。PRP后1个月以及3 - 6个月时黄斑厚度显著增加(<0.05),而视乳头周围视网膜神经纤维层(RNFL)和神经节细胞复合体(GCC)厚度在术后1个月显著增加(<0.01)。在同一时间点,整体损失体积和局灶性损失体积显著降低(<0.05)。12个月随访期间BCVA、VD、RNFL和GCC厚度以及SFCT未发生变化,提示PRP可能预防视网膜神经血管和脉络膜损伤。