Original Articles
One-year outcomes of panretinal photocoagulation in proliferative diabetic retinopathy

https://doi.org/10.1016/S0002-9394(99)00322-0Get rights and content

Abstract

PURPOSE:

To describe the clinical features and complications of diabetic retinopathy, visual acuity, and number of repeat treatments after panretinal photocoagulation for proliferative diabetic retinopathy in a tertiary care center.

METHODS:

A cohort study was conducted with data collection from medical records of patients undergoing panretinal photocoagulation between 1985 and 1995 at the Scheie Eye Institute; 297 eyes of 186 patients were eligible for study.

RESULTS:

The presence of neovascularization of the disk at baseline, an earlier onset of diabetes, and a shorter duration of disease before panretinal photocoagulation were the strongest risk factors for needing an additional panretinal photocoagulation treatment. Sixty-two percent of eyes with poor visual acuity (≤20/200) at baseline still had poor visual acuity at 1 year, and 76% with good visual acuity (≥20/40) at baseline maintained good visual acuity at 1 year. Poor vision at baseline was the only risk factor for having poor vision at 1 year. Vitreous hemorrhage was present in 44% of eyes at baseline. New vitreous hemorrhage developed in 37% of eyes during the first year after panretinal photocoagulation. A traction retinal detachment was present in 4% of eyes at baseline and newly developed in 6% of eyes during follow-up. A repeat panretinal photocoagulation treatment was performed in 39% of eyes after initial treatment. A vitrectomy was performed in 10% of eyes from baseline through the 1-year follow-up visit.

CONCLUSIONS:

The data from this study are useful for counseling patients with respect to likely visual outcome, possibility of major complications from proliferative diabetic retinopathy, and the chance of undergoing additional laser treatment after panretinal photocoagulation.

Section snippets

Patients and methods

We identified a cohort of patients’ eyes treated with initial panretinal photocoagulation at the Scheie Eye Institute from 1985 through 1995 and followed up for at least 1 year. Candidate patients and eyes were obtained from a registry of diagnostic codes, maintained by the retina service, of patients who were diagnosed with proliferative diabetic retinopathy. Eyes of patients were identified that met the following criteria: proliferative diabetic retinopathy treated with panretinal

Results

Charts were obtained and reviewed for 530 patients. Of the reviewed charts, 261 patients (49%) did not meet the criteria for the study. One hundred forty-three patients (27%) never underwent panretinal photocoagulation at the Scheie Eye Institute, 82 patients (15%) underwent previous panretinal photocoagulation at another institution, and 36 patients (7%) had panretinal photocoagulation before 1985. Among the remaining 269 eligible patients, 83 patients (31%) underwent their initial panretinal

Discussion

The study data document that 30 eyes (10%) underwent a vitrectomy within 1 year of initial panretinal photocoagulation treatment, approximately twice the Early Treatment Diabetic Retinopathy Study 5-year cumulative rate of pars plana vitrectomy of 5.3%.16 Our data most likely differ from Early Treatment Diabetic Retinopathy Study data because of the difference in eye status at the time of initial panretinal photocoagulation. The eligibility criteria of the Early Treatment Diabetic Retinopathy

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Cited by (0)

This study was supported in part by National Eye Institute grant R21 EY10964, National Institutes of Health, Bethesda, Maryland, and an unrestricted grant from Research to Prevent Blindness, Inc, New York, New York.

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