Peripapillary retinal nerve fiber layer thickness change after panretinal photocoagulation in patients with diabetic retinopathy

Purpose: To examine the effect of panretinal photocoagulation (PRP) on the retinal nerve fiber layer (RNFL) thickness in patients with diabetic retinopathy.

Methods: Subjects included 118 eyes for a treatment group and 164 eyes for a control group. The peripapillary RNFL thickness was measured before and 6 months after PRP in treatment group. In control group, the peripapillary RNFL thickness was measured at baseline and 6 months later. The relationships between changes in RNFL thickness and the number of laser burns, duration of diabetes, HbA1c level, and vision change were analyzed.

Results: After 6 months, the RNFL thickness decreased an average of 2.12 microm and 0.93 microm in the treatment and control groups. However, the changes between the two groups were not statistically significant. The relationship between the number of laser burns and changes in RNFL thickness was not significant. No differences were found between changes in the RNFL thickness and the duration of diabetes in either group. However, in the treatment group a higher HbA1c level was correlated with a greater decrease in post-PRP RNFL thickness. This relationship was not observed in the control group. The difference in the change of the RNFL thickness between the two groups was statistically significant. Vision increased an average of 0.02 and 0.01 after 6 months in the treatment and control groups, respectively. However, this difference was not statistically significant.

Conclusions: Although a decrease in peripapillary RNFL thickness was observed in the treatment group after 6 months, it was not statistically significant compared to control group. However, the decrease was greater when the blood HbA1c level was higher.