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Br J Ophthalmol. 2018 Aug 1. pii: bjophthalmol-2018-312195. doi: 10.1136/bjophthalmol-2018-312195. [Epub ahead of print]

Peripheral capillary non-perfusion in treatment-naïve proliferative diabetic retinopathy associates with postoperative disease activity 6 months after panretinal photocoagulation.

Author information

1
Department of Ophthalmology, Odense University Hospital, Odense, Denmark thomas.lee.torp@rsyd.dk.
2
Department of Clinical Research, University of Southern Denmark, Odense, Denmark.
3
Department of Vision Informatics, Osaka University Graduate School of Medicine, Osaka, Japan.
4
Singapore National Eye Centre, Duke-NUS Medical School, National University of Singapore, Singapore.
5
School of Medicine, Dentistry and Biomedical Sciences, Queen's University Belfast, Belfast, UK.
6
Department of Ophthalmology, Odense University Hospital, Odense, Denmark.

Abstract

BACKGROUND/AIMS:

With the perspective to provide individualised panretinal laser photocoagulation (PRP) for proliferative diabetic retinopathy (PDR), we evaluated if retinal peripheral capillary non-perfusion (PCNP) and oximetry, as non-invasive markers of retinal metabolism and function, could predict disease activity 6 months after PRP.

METHODS:

We performed a prospective, interventional study of patients with treatment-naïve PDR. Retinal oximetry and ultra-widefield fluorescein angiography were performed at baseline (BL) and three (3M) and 6 months (6M) after PRP by a navigated laser system. At 6M follow-up, patients were divided according to disease activity: active or inactive.

RESULTS:

We included 33 eyes, and 69.6% were men. At BL, the median age and duration of diabetes (with IQRs) were 51.6±23.4 and 20.0±15.0 years. Haemoglobin A1c was 63.0±17.0 mmol/mol and blood pressure was 152±37/82±24 mm Hg. At BL and M6, patients with postoperative disease activity (30.3.%, n=10) had a larger area with PCNP than those with inactive PDR (BL: 51%-75% vs 26%-50%, p=0.03; 6M: 51%-75% vs 26%-50%, p=0.03). The area of PCNP did not change from BL to 6M in either group (inactive PDR: p=0.38, active PDR: p=0.87). Changes in retinal oxygen saturation were not found to be clinical relevant.

CONCLUSION:

We found the area of PCNP at all timepoints to be statistically larger in patients with active PDR 6 months after PRP treatment. Therefore, the area of PCNP, at baseline, may serve as a potential predictive marker for PDR activity after treatment.

KEYWORDS:

clinical trial; imaging; neovascularisation; retina; treatment lasers

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