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  Vol. 127 No. 7, July 2009 TABLE OF CONTENTS
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Effect of Diabetic Retinopathy and Panretinal Photocoagulation on Retinal Nerve Fiber Layer and Optic Nerve Appearance

Michele C. Lim, MD; Suzana A. Tanimoto, MD; Bruno A. Furlani, MD; Brent Lum, BS; Luciano M. Pinto, MD; David Eliason, MD; Tiago S. Prata, MD; James D. Brandt, MD; Lawrence S. Morse, MD, PhD; Susanna S. Park, MD, PhD; Luiz A. S. Melo Jr, MD

Arch Ophthalmol. 2009;127(7):857-862.

Objective  To determine if panretinal photocoagulation (PRP) alters retinal nerve fiber layer (RNFL) thickness and optic nerve appearance.

Methods  Patients with diabetes who did and did not undergo PRP and nondiabetic control subjects were enrolled in a prospective study. Participants underwent optical coherence tomography of the peripapillary retina and optic nerve. Stereoscopic optic nerve photographs were graded in a masked fashion.

Results  Ninety-four eyes of 48 healthy individuals, 89 eyes of 55 diabetic patients who did not undergo PRP, and 37 eyes of 24 subjects with diabetes who underwent PRP were included in this study. Eyes that had been treated with PRP had thinner peripapillary RNFL compared with the other groups; this was statistically significantly different in the inferior (P = .004) and nasal (P = .003) regions. Optic nerve cupping did not increase with severity of disease classification, but the proportion of optic nerves graded as suspicious for glaucoma or as having nonglaucomatous optic neuropathy did (P = .008). These grading categories were associated with thinner RNFL measurements.

Conclusions  Diabetic eyes that have been treated with PRP have thinner RNFL than nondiabetic eyes. Optic nerves in eyes treated with PRP are more likely to be graded as abnormal, but their appearance is not necessarily glaucomatous and may be related to thinning of the RNFL.


Author Affiliations: Department of Ophthalmology & Vision Science, University of California–Davis, Sacramento (Drs Lim, Tanimoto, Eliason, Brandt, Morse, and Park, and Mr Lum); and the Department of Ophthalmology, Federal University of São Paulo, São Paulo, Brazil (Drs Furlani, Pinto, Prata, and Melo).



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THIS ARTICLE HAS BEEN CITED BY OTHER ARTICLES

Early diabetic changes in the nerve fibre layer at the macula detected by spectral domain optical coherence tomography
Park et al.
Br J Ophthalmol 2011;95:1223-1228.
ABSTRACT | FULL TEXT  





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