Reply to ‘Can photoreceptor loss also account for changes in pupil size following panretinal photocoagulation?’

Sir,

We thank the authors for showing interest in our study¹ and for their valuable contributions.

In our study, we aimed to evaluate the possible changes in pupil size subsequent to panretinal laser photocoagulation (PRP) via Conventional laser and pattern scan laser (PASCAL). We found out that the pupil size increases (according to objective pupillary measurements) following PRP in patients with proliferative diabetic retinopathy (PDR).¹ Although we have not known the exact underline mechanism of pupillary size changes, we hypothesize that it may be secondary to damage to short posterior ciliary nerves, which transverse the suprachoroidal space. There are some minor studies in literature that supported our hypothesis.^{2, 3}

The authors pointed out to a good hypothesis that the damaged peripheral retinal photoreceptors following PRP may be a partially mechanism, which explains the increased pupil size after PRP.⁴ Additional studies are required to find out the exact underline mechanism.

The authors also added that it would be of great benefit if we could clarify whether the untreated eye was also exposed to light during the direct pupillometric measurement and whether anisocoria was observed.⁴ However, we do not have the pupillometry measurements of non-studied eyes.