| PURPOSE: To observe the changes of macular vessel density in the superficial capillary plexus and deep capillary plexus by optical coherence tomography angiography automate quantification system in severe non-proliferative diabetic retinopathy after panretinal photocoagulation,as well as the changes of central macular thickness and the best corrected visual acuity.METHODS: In the before and after self control study,we included thirty-four eyes of 21 patients with severe non-proliferative diabetic retinopathy,including 12 males(20 eyes),9 females(14 eyes),aged 40-63 years,median age is51 years,mean age(51.09±7.18)years old,the duration of diabetes is 6 to156 months,and the average is(68.47±49.21)months.The OCTA examination was performed in the day before panretinal photocoagulation,1 week and 1month after panretinal photocoagulation.OCTA was performed on a 6mm ×6mm macular region centered on the fovea with the HD Angio-retina 6mm scanning mode and automatically segmented into superficial retina capillary plexus and deep retina capillary plexus according to the built-in software.The superficial retina capillary plexus and deep retina capillary plexus in the range of6 mm×6 mm in the macular area and 1 mm diameter circle in the fovea were recorded and automatically quantified to the vessel density.The changes of macular vessel density,central macular thickness and best corrected visual acuitywere observed and compared before and after PRP.RESULTS:The mean interval of follow-up OCTA was 7.41±0.80 days(6-9 days)and 31.81±2.16 days(28-35 days).The vessel density of the superficial retinal capillary plexus in macular area with 6mm × 6mm range size was37.62×2.84%,39.12±4.27% and 39.19±3.60%,P=0.368(>0.05);the vessel density of deep retinal capillary plexus was 40.47±5.62%,40.29±10.15% and43.89±6.14%,P=0.019(<0.05),statistically significant differences;The vessel density of the superficial capillary plexus within the 1 mm diameter of the fovea was15.92±9.30%,13.30±9.47%,and18.03±11.42%,P=0.056(>0.05);The vascular density of the deep capillary plexus was 27.61±8.96%,24.66±14.56% and29.62±12.27%,P=0.113(>0.05).The vessel density of the superficial and deep capillary plexus in the macular area have increased to some degrees both in 1week and 1 month after PRP.The central macular thickness was(351.00±109.15)μm,(373.94±160.33)μm and(416.29±174.91)μm,P=0.009(<0.05),and the best corrected visual acuity was 0.46±0.23,0.42±0.24 and0.36±0.20,P=0.059(>0.05),after the PRP,the thickness of the fovea was thicker than before,and the best corrected visual acuity reduced to some extent.COMCLUSION: The macular perfusion improves in a short term in the patients of severe non-proliferative diabetic retinopathy after panretinal photocoagulation.After panretinal photocoagulation in patients with diabetic macular edema,the macular edema may be aggravated and the best corrected visual acuity is not improved in a short period of time.As a non-invasive test,OCTA has good reproducibility and can provide a favorable basis for evaluatingthe prognosis of patients with diabetic retinopathy after panretinal photocoagulation. |
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