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PRP could cause optic nerve changes
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SAN FRANCISCO — Diabetic eyes treated with panretinal laser photocoagulation have significantly thinner retinal nerve fiber layers, which could be mistaken for glaucomatous damage, according to a specialist speaking here.
Michele C. Lim, MD, and colleagues conducted a study involving 77 eyes of healthy individuals, 75 eyes of patients with diabetes who had early to moderate diabetic retinopathy (DR), 15 eyes of patients with severe nonproliferative or proliferative DR and 44 eyes of patients treated with panretinal laser photocoagulation (PRP).
Dr. Lim presented the results at the American Glaucoma Society annual meeting. In all cases, optical coherence tomography, performed using the Stratus OCT (Carl Zeiss Meditec), was used to measure retinal nerve fiber layer (RNFL) thickness, Dr. Lim said. The researchers found a trend in RNFL in PRP-treated eyes compared with untreated eyes of diabetic patients. Changes to the RNFL were found in the superior and inferior peripapillary quadrants, she said.
"The big question is: 'Why is there no evidence of nerve cupping in these patients?'" Dr. Lim said. "The absence of cupping reinforces the idea that glaucoma damage is not just about ganglion [cell] death."