Routine, single session, indirect laser for proliferative diabetic retinopathy

Abstract

Aims To evaluate the visual and morphological outcomes of routine, single session, indirect panretinal photocoagulation (PRP) for proliferative diabetic retinopathy, and to examine adverse events related to indirect laser within the first 8 weeks of treatment. Methods The case notes of 107 diabetics with proliferative retinopathy undergoing indirect PRP were reviewed retrospectively, and compared with the UK National Diabetic Retinopathy Laser Treatment Audit. Patients who had received PRP previously were excluded. Follow-up data were collected as close as possible to 9 months following the initial laser treatment. Results Fifteen patients (14.0%) returned with adverse events within the first 8 weeks of indirect PRP. There were two tractional retinal detachments and two new vitreous haemorrhages. One patient with underlying neurotrophic keratopathy developed a persistent epithelial defect. One developed non-progressive macular drag with a one-line drop in Snellen acuity. Three experienced new or exacerbations of preexisting clinically significant macular oedema, which resolved spontaneously. There were two transient choroidal effusions, two transient anterior uveitis, and two transient visual deteriorations without macular oedema clinically. There were no significant differences in the rates of new tractional retinal detachment, vitreous haemorrhage or rubeosis, but our vitrectomy rate was higher (7.5 vs 1.5%, P ¼ 0.02, v 2 ), largely due to our policy of performing vitrectomy early. Conclusions Visual and morphological outcomes of routine, single session, indirect PRP for proliferative diabetic retinopathy were not inferior to the outpatient-based national audit, and the incidence of significant PRP-induced adverse events was low.

Role of Pan Retinal Photo Coagulation in The Management of Proliferative Diabetic Retinopathy

“…In the present study Panretinal photocoagulation is well tolerated by the patients, without interfering significantly with their quality of life in accordance with the study made by Tsilimbaris MK et al all studied on 20 patients with bilateral proliferative diabetic retinopathy treated with panretinal photocoagulation his study revealed that Panretinal photocoagulation although destructive in nature, is well tolerated by the patients, without interfering significantly with their quality of life 11 PRP significantly reduces the risk of severe vision loss in PDR patients by 50% in accordance with the study done by ETDRS and DRS control trials. In our study also, 80 eyes who underwent PRP visual acuity improved in 21.1%, visual acuity was maintained in 70.6% and decreased in 8.2% which was more than the ETDRS and DRS studies.…”

Study of clinical profile and management of vitreous haemorrhage

“…In our study was 10% recurrence was noted in patients treated with photocoagulation. Other author also found the good results by photocoagulation [7,11,12,13]. In this study there were 10 cases where vitreous haemorrhage persisted for 6 month.…”

Correlation with OCT and histology of photocoagulation lesions in patients and rabbits

“…The early rabbit OCT shows shallow exudative retinal detachment, which we have also observed in rabbit histology (not shown), but not in patient OCT. Here, overtreatment would rather cause choroidal effusion (Tinley & Gray 2009). Figure 4 shows linear regression analyses of ophthalmoscopical lesion diameters and OCT or histological GLD's, respectively.…”