Effect of Panretinal Photocoagulation on Macular and Peripapillary Nerve Fiber Layer Thickness in Patients with Proliferative Diabetic Retinopathy and Correlation with Visual Acuity

Mostafa, Khaled Elsayed Moawad; Mohamed, Mohamed Khedr; Abdelsalam, Mohamed Eid

doi:https://doi.org/10.21608/aimj.2025.446578

Effect of Panretinal Photocoagulation on Macular and Peripapillary Nerve Fiber Layer Thickness in Patients with Proliferative Diabetic Retinopathy and Correlation with Visual Acuity

Document Type : Original Article

Authors

¹ Department of Ophthalmology, National Eye Center – Rod El Farag, Cairo, Egypt

² Department of Ophthalmology, Faculty of Medicine for Boys, Al-Azhar University, Cairo, Egypt

https://doi.org/10.21608/aimj.2025.446578

Abstract

Background: Diabetes mellitus is a metabolic disorder characterized by an inability to properly use glucose, leading to hyperglycemia and, eventually, serious eye pathology. Among people of working age around the world, diabetic retinopathy is the most common cause of blindness.
Aim of the work: To evaluate the impact of panretinal photocoagulation on visual acuity, Thickness of the macula, and peripapillary nerve fiber layer in proliferative diabetic retinopathy patients.
Patients and Methods: As part of this prospective interventional study, carried on 20 eyes of 20 PDR patients aiming to assess changes of macular Thickness, peripapillary NFLT using OCT and visual acuity changes following PRP. The study was conducted at the ophthalmology department, Al-Azhar university hospitals and the National eye centre, Egypt.
Results: Nne men and eleven women made up the population of this study. Their average age was 52.65years, with a standard deviation of 7.02years. Their average diabetes duration was 16.3years with a standard deviation of 4.24 years. Their average HbA1c was 9.65 with a standard deviation of 1.44. The population of the study was subjected to three sessions of PRP, one week apart, with documentation of macular Thickness, peripapillary NFLT, and visual acuity pre- and post-PRP, 3 months apart. Uncorrected and best corrected visual acuity increases in all populations following PRP with a statistically highly significant value (p-value <0.001). Central macular Thickness of the entire population decreases, and "improved oedema" follows PRP with statistically moderate significance (p-value=0.004). Changes in peripapillary NFLT of the population varied between different quadrants; statistically insignificant in temporal (p-value=0.074) and superior (p-value=0.542) quadrants, but statistically significant in nasal (p-value=0.026) and inferior (p-value=0.008) quadrants.
Conclusion: The results of this study show that panretinal photocoagulation (PRP) is a safe and effective way to treat and preserve vision in proliferative diabetic retinopathy (PDR). PRP works by improving the retina's ischemic status and by affecting macular Thickness, which could help with macular oedema. Optical coherence tomography (OCT) is a crucial tool for diagnosing and monitoring a wide range of eye diseases and evaluating the effectiveness of different treatment options.

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