Florid diabetic retinopathy (FDR): a long-term follow-up study.
OBJECTIVE
To evaluate efficacy of laser photocoagulation and pars-plana vitrectomy in patients with FDR.


METHODS
Eighty-eight patients (155 eyes) with FDR were retrospectively evaluated (mean age 27 +/- 6.0 years; proportion of females 66%; insulin-dependent diabetes 100%; mean duration of diabetes 16.5 +/- 5.8 years; poor metabolic control 83%). The eyes were divided in two groups: group I: 136 eyes amenable to laser photocoagulation and, when necessary, to vitrectomy afterwards (45/136); group II: 19 eyes subjected directly to vitrectomy.


RESULTS
In group I (mean follow-up 54.2 +/- 38.7 months) the initial visual acuity (IVA) was 0.61 +/- 0.30 and the final visual acuity (FVA) was 0.47 +/- 0.34; in the 45 vitrectomized eyes IVA was 0.15 +/- 0.24 and FVA was 0.19 +/- 0.25. FDR regressed in 75% and worsened in 25% of the cases. In group II (mean follow-up 46.4 +/- 36.3 months) IVA was 0.1 +/- 0.14 and FVA 0.14 +/- 0.22. FDR regressed in 32% and worsened in 68% of cases.


CONCLUSIONS
FDR remains a cause of severe visual impairment in diabetics. Patients at risk of FDR are young females with long-standing, poorly controlled insulin-dependent diabetes. Panretinal laser photocoagulation prior to vitrectomy is beneficial; information on this severe form of retinopathy is essential to ensure prompt diagnosis and improve its unfavorable clinical course.
Lattanzio
R
R
Department of Ophthalmology & Visual Sciences, University Hospital S. Raffaele, Via Olgettina 60, 20132 Milan, Italy.
Brancato
R
R
Bandello
F M
FM
Azzolini
C
C
Malegori
A
A
Maestranzi
G
G
D000328:Adult; D003922:Diabetes Mellitus, Type 1 / Q000150:complications; D003930:Diabetic Retinopathy / Q000503:physiopathology* / Q000601:surgery; D005260:Female; D005451:Fluorescein Angiography; D005500:Follow-Up Studies; D006801:Humans; D017075:Laser Coagulation; D008297:Male; D012189:Retrospective Studies; D014792:Visual Acuity; D014821:Vitrectomy