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

doi:10.3341/jkos.2018.59.10.938

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Yoon, Park, and Kim: Long-term Changes in the Peripapillary RNFL and Macular GCIPL Thicknesses after Panretinal Photocoagulation in Diabetic Retinopathy Patients

Original Article

Journal of the Korean Ophthalmological Society 2018; 59(10): 938-945.

Published online: 17 October 2018

DOI: https://doi.org/10.3341/jkos.2018.59.10.938

Long-term Changes in the Peripapillary RNFL and Macular GCIPL Thicknesses after Panretinal Photocoagulation in Diabetic Retinopathy Patients

Jung Hyun Yoon, MD^1,², Dong Ho Park, MD, PhD^1,², Dai Woo Kim, MD, PhD^1,²

¹Department of Ophthalmology, School of Medicine, Kyungpook National University, Daegu, Korea.

²Department of Ophthalmology, Kyungpook National University Hospital, Daegu, Korea.

Address reprint requests to Dai Woo Kim, MD, PhD. Department of Ophthalmology, Kyungpook National University Hospital, #130 Dongdeok-ro, Jung-gu, Daegu 41944, Korea. Tel: 82-53-200-5806, Fax: 82-53-426-6552, proector97@gmail.com

Received 14 June 2018 Revised 10 July 2018 Accepted 28 September 2018

The Korean Ophthalmological Society

(open-access):

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Purpose

To investigate longitudinal changes in the thicknesses of the peripapillary retinal nerve fiber layer (pRNFL) and the macular ganglion cell-inner plexiform layer (mGCIPL) in patients with diabetic retinopathy 3 years after panretinal photocoagulation (PRP).

Methods

We retrospectively reviewed the medical records of 60 eyes of 35 patients who were diagnosed with diabetic retinopathy and treated with PRP. The pRNFL and mGCIPL thicknesses were measured by optical coherence tomography at baseline, and then at 1, 3, 6, 9, 12, 24, and 36 months after PRP.

Results

The pRNFL and mGCIPL thicknesses (average and all sections) at 1 year after PRP increased significantly from baseline (p < 0.05, respectively). The average pRNFL and mGCIPL thicknesses showed a tendency to decrease continuously from 2 years after PRP (p < 0.05, respectively). There was no statistically significant difference in the average thicknesses of the pRNFL and the mGCIPL between pre-PRP (92.27 ± 7.76 µm, and 85.00 ± 4.80 µm, respectively) and 3 years after PRP (93.93 ± 7.49 µm, and 81.87 ± 14.00 µm, respectively) (p = 0.121, and p = 0.622, respectively).

Conclusions

Although the pRNFL and the mGCIPL thicknesses increased at 1 year after PRP, there was no statistical difference in the average thicknesses of the pRNFL and the mGCIPL between pre-PRP and 3 years after PRP. These results should be considered with respect to the diagnosis and progression of glaucoma in patients with diabetic retinopathy who undergo PRP.

Keywords: Diabetic retinopathy, Ganglion cell-inner plexiform layer thickness, Glaucoma, Panretinal photocoagulation, Retinal nerve fiber layer thickness

Figures and Tables

Figure 1

Peripapillary retinal nerve fiber layer (RNFL) and macular ganglion cell-inner plexiform layer (GCIPL) thickness in Cirrus optical coherence tomography (OCT). (A) OCT shows the RNFL thicknesses of average and four-quadrant in both eyes. (B) OCT shows GCIPL thicknesses of average and six-sector in both eyes. OD = oculus dexter; OS = oculus sinister; GCL = ganglion cell layer; IPL = inner plexiform layer; S = superior; T = temporal; N = nasal; I = inferior; NA = non-available.

Figure 2

Longitudinal changes in the average and four-quadrant thicknesses (µm) of the peripapillary retinal nerve fiber layer (RNFL) after panretinal photocoagulation (PRP). The RNFL thicknesses (average and four-quadrant) increased at 1 month after PRP and had declined continuously since then (A–E). Repeated-measures analysis of variance corrected by Bonferroni method showed that the RNFL thicknessess (average and four-quadrant) increased at 1 year after PRP (all p < 0.05), but there was no statistically significant difference of the average, inferior, nasal and temporal thicknesses of the RNFL between pre-PRP and 3 years after PRP (A, C–E). The superior RNFL thickness (93.93 ± 7.49 µm) decreased at 3 years after PRP from the thickness (92.27 ± 7.76 µm) before PRP (p = 0.442) (B). ^*p < 0.05 by repeated-measures analysis of variance corrected by the Bonferroni methods; ^†p < 0.05 by paired t-test.

Figure 3

Longitudinal changes in the average and six-sector thicknesses (µm) of the macular ganglion cell-inner plexiform layer (GCIPL) after panretinal photocoagulation (PRP). Repeated-measures analysis of variance corrected by Bonferroni method showed that macular GCIPL thicknesses (average and 6-sector) increased in 1 year after PRP (all p < 0.05). The average GCIPL thickness showed a tendency to increase until 1 year, but to decrease continuously from 2 year after PRP. There was no statistically significant difference of the average, superior, superonasal, inferior, inferotemporal and superotemporal GCIPL thicknesses between pre-PRP and 3 years after PRP (A–C, E–G). The inferonasal GCIPL thickness (81.87 ± 19.0 µm) decreased at 3 years after PRP from the thickness (85.00 ± 4.80 µm) before PRP (p = 0.544) (D). ^*p < 0.05 by repeated-measures analysis of variance corrected by the Bonferroni methods; ^†p < 0.05 by by paired t-test.

Table 1

Demographics and clinical data

Values are presented as mean ± SD or n (%) unless otherwise indicated.

OD = oculus dexter; OS = oculus sinister; HTN = hypertension; DM = diabetes mellitus; HbA1c = hemoglobin A1c; BCVA = best-corrected visual acuity; IOP = intraocular pressure; DR = diabetic retinopathy; NPDR = non-proliferative diabetic retinopathy; PDR = proliferative diabetic retinopathy.

Table 2

Longitudinal changes in peripapillary retinal nerve fiber layer thickness after panretinal photocoagulation

Values are presented as the mean ± standard deviation.

^*Repeated-measures analysis of variance corrected by the Bonferroni methods; ^†Paired t-test compared with the previous observation period.

Table 3

Longitudinal changes in macular ganglion cell-inner plexiform layer thickness after panretinal photocoagluation

Values are presented as the mean ± standard deviation.

^*Repeated-measures analysis of variance corrected by the Bonferroni methods; ^†Paired t-test compared with the previous observation period.

Notes

Dong Ho Park was financially supported by the Basic Science Research Program of the National Research Foundation of Korea (NRF), funded by the Ministry of Education (NRF-2017R1D1A1B03027966), and the Korea Health Technology R&D Project of the Korea Health Industry Development Institute (KHIDI), funded by the Ministry of Health & Welfare, Republic of Korea (HI16C1501).

Dai Woo Kim was financially supported by the Basic Science Research Program of the National Research Foundation of Korea (NRF), funded by the Ministry of Education (NRF-2017R1D1A1B03035483).

^{Conflicts of Interest} The authors have no conflicts to disclose.

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