Evaluating the influence of panretinal photocoagulation and intravitreal bevacizumab on optic disc circulation in patients with diabetic retinopathy
Arash Mirzaei1 *, Hassan Khojasteh2 , Mohammad Ahadi Fard Moghadam1 , Masoud Rahimi1 , Fariba Ghassemi1 , Hooshang Faghihi1 , Elias Khalili Pour1 , Hamid Riazi-Esfahani1 , Alireza Takzare3
- Retina Service, Farabi Eye Hospital, Tehran University of Medical Sciences, South Kargar Street, Qazvin Square, Tehran, Iran
- Retina Service, Farabi Eye Hospital, Tehran University of Medical Sciences, South Kargar Street, Qazvin Square, Tehran, IranRetina Service, Farabi Eye Hospital, Tehran University of Medical Sciences, South Kargar Street, Qazvin Square, Tehran, Iran
- Anaesthesiology Department, Farabi Hospital, Tehran University of Medical Sciences, Tehran, Iran
Abstract: This retrospective study aimed to assess changes in the optic disc vasculature one and three months after treatment with either panretinal photocoagulation (PRP) or intravitreal bevacizumab (IVB) in individuals with diabetic retinopathy
Methods: A total of 50 eyes from 29 patients with diabetes, none of whom had severe complications, were included in this comparative case series. Of these, 28 eyes from 15 patients were assigned to the PRP group, while 22 eyes from 14 patients were treated with biosimilar bevacizumab (Stivant® CinnaGen Co., Iran). Optical coherence tomography angiography (OCTA) was utilized to assess optic disc vascular density (VD) and retinal nerve fiber layer (RNFL) thickness
Results: The mean age of the enrolled patients was 62.1 ± 8.3 years (40 to 78 years). During follow-up, whole disc VD, inside disc VD and peripapillary VD decreased significantly in the PRP group at month 1 (p=0.032, p=0.32, and p=0.016, respectively) and month 3 (p=0.004, p=0.001 and p=0.011, respectively). There was an insignificant and slight increase for these parameters in the IVB group. (p>0.05 for all) A comparison of two treatment arms based on mean whole disc VD, inside disc VD, and peripapillary VD changes revealed a significant difference at month 1 (p=0.009, p=0.019, and p=0.002, respectively) and month 3 (p=0.002, p=0.015, and p=0.009, respectively). Peripapillary RNFL thickness increased in the PRP group at month 1 (p=0.002) and then decreased at month 3 (p=0.001). During three months of follow-up, the peripapillary RNFL thickness decreased significantly in the IVB group (p=0.001). Peripapillary RNFL thickness changes were significantly different between treatment groups at month 1 and month 3. (p=0.001 for both) The RNFL changes during the study did not significantly correlate with peripapillary VD changes in each group (p=0.231 and p=372, for PRP and IVB group, respectively)
Conclusion: This study demonstrated that IVB and PRP treatments produced distinct short-term microvascular changes in the optic nerve of diabetic retinopathy patients. PRP treatment led to a significant reduction in vascular density in the optic disc and peripapillary region over 3 months, with an initial increase in RNFL thickness followed by a decrease
