Effect of panretinal photocoagulation on retinal blood flow in proliferative diabetic retinopathy.

The effect of panretinal photocoagulation (PRP) on retinal volumetric blood flow rate and its regulatory response to hyperoxia was investigated in a main temporal vein of 15 eyes with proliferative diabetic retinopathy, using bi-directional laser Doppler velocimetry and monochromatic fundus photography. At an average of 4 +/- 2 months after the beginning of PRP, retinal venous diameter decreased from an average of 174 +/- 20 micron to 162 +/- 19 micron (P less than 0.01), red blood cell velocity decreased from 1.3 +/- 0.4 cm/sec to 1.1 +/- 0.4 cm/sec (P less than 0.01), and blood flow decreased from 11.5 +/- 3.8 microliter/min to 8.4 +/- 3.3 microliter/min (P less than 0.001). The regulatory response to hyperoxia, characterized by the percentage decrease in retinal blood flow during 100% oxygen breathing, improved from 20 +/- 15% prior to treatment to 45 +/- 12% following treatment (P less than 0.001). The decrease in retinal blood flow is most likely due to a decrease in viable retinal tissue and an improvement in retinal oxygenation following PRP. The increase in the regulatory response to 100% O2 breathing following PRP may also result from such an improved retinal oxygenation.