title: Effects of photocoagulation on ocular blood flow in patients with severe non-proliferative diabetic retinopathy.
abstract: OBJECTIVE
  To investigate ocular blood flow and correlations between ocular blood flow and variables in patients with severe non-proliferative diabetic retinopathy (S-NPDR) following panretinal photocoagulation (PRP).
  
  
  METHODS
  In this retrospective, cross-sectional study, the blood flow on the optic nerve head (ONH) and choroid was assessed with laser speckle flowgraphy (LSFG) using the mean blur rate (MBR) in 76 eyes of 76 patients with S-NPDR who underwent PRP, 39 eyes of 39 patients with S-NPDR who did not undergo PRP, and 71 eyes of 71 normal subjects. The correlation between MBR and variables, including visual acuity (VA) and choroidal area determined by binarization method, was analyzed.
  
  
  RESULTS
  The mean age was 62.9 ± 11.9 years in the S-NPDR with PRP eyes, 55.6 ± 11.4 years in the S-NPDR without PRP eyes, and 60.3 ± 11.1 years in the normal subject eyes. The ONH MBR in vessel and tissue areas and the choroidal MBR were significantly lower in the S-NDR with PRP group than in the other groups (p < 0.001, p < 0.001, and p < 0.001, respectively). The luminal and the stromal areas were significantly smaller in the S-NDR with PRP group than in the other groups (p < 0.001 and p < 0.001, respectively). LogMAR best corrected visual acuity (BCVA) exhibited significant negative correlation with the ONH MBR in vessel (r = -0.386, p < 0.001), tissue (r = -0.348, p < 0.001), and the choroid MBR (r = -0.339, p = 0.002) in the S-NDR with PRP group. Stepwise multiple regression analysis demonstrated that BCVA was a common independent factor associated with the ONH MBR in vessel, tissue, and the choroidal MBR in the S-NDR with PRP group.
  
  
  CONCLUSIONS
  ONH and choroid MBR in addition to choroidal component, including the luminal area, were significantly lower in eyes of patients with S-NPDR after PRP compared with no PRP and normal subjects group. This could suggest that the significantly reduced ocular blood flow in PRP-treated S-NPDR eyes correlated with long-term decreased post-PRP luminal area and visual acuity.
authors.affiliation: Department of Ophthalmology, Nagoya University Graduate School of Medicine, Nagoya, Showa-ku, Japan.
authors.forename: Takeshi
authors.identifier: http://orcid.org/0000-0003-3477-7670
authors.initials: T
authors.lastname: Iwase
authors.affiliation: Department of Ophthalmology, Nagoya University Graduate School of Medicine, Nagoya, Showa-ku, Japan.
authors.forename: Misato
authors.initials: M
authors.lastname: Kobayashi
authors.affiliation: Department of Ophthalmology, Nagoya University Graduate School of Medicine, Nagoya, Showa-ku, Japan.
authors.forename: Kentaro
authors.initials: K
authors.lastname: Yamamoto
authors.affiliation: Department of Ophthalmology, Nagoya University Graduate School of Medicine, Nagoya, Showa-ku, Japan.
authors.forename: Eimei
authors.initials: E
authors.lastname: Ra
authors.affiliation: Department of Ophthalmology, Nagoya University Graduate School of Medicine, Nagoya, Showa-ku, Japan.
authors.forename: Hiroko
authors.initials: H
authors.lastname: Terasaki
mesh_terms: D000328:Adult; D000368:Aged; D001783:Blood Flow Velocity; D016022:Case-Control Studies; D002829:Choroid / Q000098:blood supply / Q000473:pathology; D003430:Cross-Sectional Studies; D003924:Diabetes Mellitus, Type 2 / Q000150:complications*; D003930:Diabetic Retinopathy / Q000628:therapy*; D005260:Female; D006801:Humans; D017075:Laser Coagulation; D008297:Male; D008875:Middle Aged; D009898:Optic Disk / Q000098:blood supply; D012039:Regional Blood Flow / Q000528:radiation effects*; D012189:Retrospective Studies; D016896:Treatment Outcome