The effect of laser pan-retinal photocoagulation with or without intravitreal bevacizumab injections on the OCT-measured macular choroidal thickness of eyes with proliferative diabetic retinopathy

Rony C Preti, Anibal Mutti, Daniel A Ferraz, Leandro C Zacharias, Yoshitaka Nakashima, Walter Y Takahashi, Mario L R Monteiro, Rony C Preti, Anibal Mutti, Daniel A Ferraz, Leandro C Zacharias, Yoshitaka Nakashima, Walter Y Takahashi, Mario L R Monteiro

Abstract

Objectives:: To investigate the effect of laser pan-retinal photocoagulation with or without intravitreal bevacizumab injections on macular choroidal thickness parameters in eyes with high-risk proliferative diabetic retinopathy.

Methods:: High-risk proliferative diabetic retinopathy patients undergoing laser treatment were prospectively enrolled in this study. One eye was randomly selected for laser treatment combined with bevacizumab injections, study group, whereas the corresponding eye was subjected to laser treatment alone, control group. Spectral-domain optical coherence tomography with enhanced depth imaging was used to measure the macular choroidal thickness prior to and 1 month after treatment. Measurements in both groups were compared. Clinicaltrials.gov: NCT01389505.

Results:: Nineteen patients (38 eyes) with a mean±standard deviation age of 53.4±9.3 years were evaluated, and choroidal thickness measurements for 15 patients were used for comparison. The greatest measurement before treatment was the subfoveal choroidal thickness (341.68±67.66 μm and 345.79±83.66 μm for the study and control groups, respectively). No significant difference between groups was found in terms of macular choroidal thickness measurements at baseline or after treatment. However, within-group comparisons revealed a significant increase in choroidal thickness parameters in 10 measurements in the study group and in only 5 temporal measurements in the control group when 1-month follow-up measurements were compared to baseline values.

Conclusions:: The macular choroidal thickness does not appear to be significantly influenced by laser treatment alone but increases significantly when associated with bevacizumab injections in patients with proliferative diabetic retinopathy and macular edema. Because bevacizumab injections reduce short-term laser pan-retinal photocoagulation-induced macular edema, our findings suggest that the choroid participates in its pathogenesis.

Conflict of interest statement

No potential conflict of interest was reported.

Figures

Figure 1
Figure 1
Schematic representation of the study protocol (between-group comparison). *intravitreal bevacizumab; **pan-retinal photocoagulation.
Figure 2
Figure 2
Mean macular choroidal thickness measurements from each group at different locations across a horizontal section through the fovea. This measurement significantly differed at the 1-month follow-up visit compared with the baseline. The error bars represent 1 standard deviation.

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