Structural and functional changes to the retina and optic nerve following panretinal photocoagulation over a 2-year time period

PurposeTo evaluate long-term structural and functional changes to the retina and optic nerve following panretinal photocoagulation (PRP) in diabetic retinopathy (DR) patients.MethodsParticipants were patients with DR requiring PRP and control patients with DR not requiring PRP. The Heidelberg retinal tomography (HRT) and optical coherence tomography (OCT) were performed to analyze the optic nerve and macula. Best-corrected visual acuity (BCVA) and visual field (VF) testing were done to measure central and peripheral vision. Wide-field fluorescein angiogram was performed to monitor the progression of diabetic ischemia. The primary outcome measure was to determine the degree of retinal and optic nerve changes before and after PRP.ResultsThere was a non-significant thickening of the macula and retinal nerve fiber layer at 6 months post laser that recovered by 24 months. Mean perfused ratio was significantly increased (P=0.02) at 12 and 24 months post laser. Independently grading patient stereophotographs, grader 1 indicated there was a non-significant increase in cup to disk ratio post laser, while grader 2 indicated a significant increase at 6 (P=0.04), 12 (P=0.02), and 24 months (P=0.005). There was a significant VF decrease (P≤0.02) at 12 and 24 months post laser with BCVA showing a non-significant trend of deteriorating results.ConclusionDespite an improvement in peripheral perfusion, there was a significant progressive decline of peripheral VF over the study period. Clinical grading of the optic nerve was more unreliable following PRP, despite the absence of significant morphological changes as detected by the OCT and HRT.

Drug use and life style among college undergraduates in 1989: a comparison with 1969 and 1978

The authors conducted anonymous questionnaire studies of drug use and life style among college seniors at the same institution in 1969, 1978, and 1989. The 1989 group of students reported strikingly lower frequencies of virtually all forms of drug use than their counterparts in 1969 and 1978. As in 1969 and 1978, the drug users among the 1989 group were indistinguishable from nonusers in grades, athletic activities, other college activities, and feelings of alienation. Only visits to a psychiatrist and sexual activity distinguished users from nonusers.