[A new photocoagulation technic for severe non-proliferative diabetic retinopathy. A prospective study apropos of 54 cases].
OBJECTIVE
This work deals with the photocoagulation treatment of severe NPDR, suggesting a new therapeutic practice. It is proposed to adopt treatment intensity to each clinical form, to preserve healthy territories through biomicroscopy and to evaluate the risk of complications inherent in this technique, and to be at least as efficient as comparative studies.


METHODS
We treated 52 eyes and kept under observation 2 eyes which revealed severe NPDR. The patients were followed between 1991 and 1996. The approach was essentially biomicroscopic. Photocoagulation treatment utilized green, yellow or orange wavelengths through panoramic contact lenses.


RESULTS
After an average follow-up of 30 months, there was a decrease of visual acuity of 0.72 to 0.64 (Monoyer scale); a severe visual loss in 1.8% of the cases; and an early decrease in visual acuity at 6 weeks in 7.4% of the cases. A "High Risk" PDR occurred in 3.7% of the cases and we had to perform a vitrectomy (1.85% of the cases). We treated with less than 1600 I in 68.5% of the cases and with more than 1600 I in 31.5% of the cases. Patients had 5.5 photocoagulation sessions and were examined every 3.5 months on average.


CONCLUSIONS
We believe our therapeutic approach is interesting, by comparison with other studies, but that it can be improved. All patients show a primary condition in the nasal field which, if treated too massively, becomes unable to see and disturbs daily life. We also note the severe potential for progression in insulin-dependent patients.
Centre Jean Abadie, Clinique Ophtalmologique du Professeur Vérin, Bordeaux.
F
F
Basteau
B
B
Mortemousque
P
P
Verin
D
D
Barac'h
M
M
Dorot
K
K
Chraibi-Asseini
D000328:Adult; D000368:Aged; D003261:Contact Lenses; D003922:Diabetes Mellitus, Type 1 / Q000503:physiopathology; D003924:Diabetes Mellitus, Type 2 / Q000503:physiopathology; D003930:Diabetic Retinopathy / Q000601:surgery*; D018450:Disease Progression; D005069:Evaluation Studies as Topic; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008028:Light Coagulation / Q000009:adverse effects / Q000379:methods*; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012307:Risk Factors; D016896:Treatment Outcome; D014786:Vision Disorders / Q000601:surgery; D014792:Visual Acuity; D014821:Vitrectomy
Nouvelle technique de photocoagulation des rétinopathies diabétiques non prolifératives sévères. Etude prospective à propos de 54 cas.