Panretinal photocoagulation versus ranibizumab for proliferative diabetic retinopathy: Comparison of peripapillary retinal nerve fiber layer thickness in a randomized clinical trial

Lee M. Jampol, Isoken Odia*, Adam R. Glassman, Carl W. Baker, Anjali M. Bhorade, Dennis P. Han, Glenn J. Jaffe, Michele Melia, Neil M. Bressler, Angelo P. Tanna

*Corresponding author for this work

Research output: Contribution to journalArticle

4 Scopus citations

Abstract

Purpose:Compare changes in retinal nerve fiber layer (RNFL) thickness between eyes assigned to intravitreous ranibizumab or panretinal photocoagulation and assess correlations between changes in RNFL and visual field sensitivity and central subfield thickness.Methods:Eyes with proliferative diabetic retinopathy were randomly assigned to ranibizumab or panretinal photocoagulation. Baseline and annual follow-up spectral domain optical coherence tomography RNFL imaging, optical coherence tomography macular imaging, and automated static perimetry (Humphrey visual field 60-4 algorithm) were performed.Results:One hundred forty-six eyes from 120 participants were analyzed. At 2 years, for the ranibizumab (N = 74) and panretinal photocoagulation (N = 66) groups, respectively, mean change in average RNFL thickness was -10.9 ± 11.7 m and -4.3 ± 11.6 m (difference, -4.9 m; 95% confidence interval [-7.2 m to -2.6 m]; P < 0.001); the correlation between change in RNFL thickness and 60-4 Humphrey visual field mean deviation was -0.27 (P = 0.07) and +0.33 (P = 0.035); the correlation between change in RNFL thickness and central subfield thickness was +0.63 (P < 0.001) and +0.34 (P = 0.005), respectively.Conclusion:At 2 years, eyes treated with ranibizumab had greater RNFL thinning than eyes treated with panretinal photocoagulation. Correlations between changes in RNFL thickness, visual field, and central subfield thickness suggest that the decrease in RNFL thickness with ranibizumab is likely due to decreased edema rather than loss of axons.

Original languageEnglish (US)
Pages (from-to)69-78
Number of pages10
JournalRetina
Volume39
Issue number1
DOIs
StatePublished - 2019

Keywords

  • panretinal photocoagulation
  • peripapillary retinal nerve fiber layer
  • proliferative diabetic retinopathy
  • ranibizumab

ASJC Scopus subject areas

  • Ophthalmology

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