Optical Coherence Tomography Angiography Assessment of Macular Choriocapillaris and Choroid Following Panretinal Photocoagulation in a Diverse Population With Advanced Diabetic Retinopathy

Purpose: The aim of this study was to evaluate choroidal and retinal microvasculature with optical coherence tomography angiography (OCTA) after panretinal photocoagulation (PRP) for diabetic retinopathy in a primarily Hispanic and Asian population. Design: Retrospective study. Methods: Eyes were examined by OCTA in the macula (3 × 3 mm) just before PRP treatment and 1 to 3 months afterwards. Choroidal thickness (CT) and central retinal thickness (CRT) were measured. Choroidal flow signal voids (CFSV) and choriocapillaris flow signal voids (CCFSV) were acquired. Retinal microvasculature parameters, including superficial and deep vessel density, superficial and deeper perfusion density, foveal avascular zone area, perimeter and circularity, were calculated. Ocular examinations and demographic information were analyzed. Results: CT at a location 1000 μm temporal to the fovea increased significantly after PRP (from 278.64 μm to 313.44 μm, P = 0.026). CCFSV increased slightly from (46.72 ± 8.52)% to (47.07 ± 10.77)%, but the difference was not statistically significant ( P = 0.782). A similar finding was observed in CFSV (increase from 35.81% to 36.64%, P = 0.165). The change in all retinal microvasculature parameters was also not significant. Best-corrected visual acuity (BCVA) decreased from 0.218 ± 0.153 to 0.262 ± 0.147 ( P = 0.034). Increased CRT (from 245.41 ± 33.18 μm to 251.14 ± 38.97 μm, P = 0.007) was observed. The change in CRT positively correlated with pre-PRP CRT ( r = 0.434, P = 0.019) and BCVA reduction ( r = 0.418, P = 0.024). Neither BCVA reduction nor CRT increase correlated with OCTA metrics. Conclusions: OCTA demonstrates redistribution of choroidal circulation from the periphery to the macula after PRP, with increased macular CT and stable choroidal blood flow density. Eyes with greater macular thickness are more likely to experience an increase in CRT.