Topographical Response of Retinal Neovascularization to Aflibercept or Panretinal Photocoagulation in Proliferative Diabetic Retinopathy

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Abstract
Proliferative diabetic retinopathy (PDR) is a common cause of visual impairment in people with diabetes. It is characterized by neovascularization (NV) of the optic nerve head and/or anywhere in the retina. Based on 7 fields and color stereoscopic fundus photographs, high-risk PDR is defined as moderate to severe NV (>1/4 to 1/3 disc diameter) of the disc (NVD), moderate NVD (1 Panretinal photocoagulation (PRP) has been the criterion standard treatment for high-risk PDR for more than 40 years2 and, on an individual basis, is also used to treat low-risk PDR and very severe nonproliferative diabetic retinopathy. Although the exact mechanism of PRP is unclear, destruction of areas of retinal capillary nonperfusion (CNP) is hypothesized to reduce the angiogenic drive from these areas. Repeated sessions of PRP may be required to cause regression of these new vessels, suggesting that some new vessels are more resistant to regression than others.2

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