Metabolic control of diabetes is associated with an improved response of diabetic retinopathy to panretinal photocoagulation.
OBJECTIVE
To study the influence of glycemic control and the presence of microalbuminuria on the initial response to panretinal photocoagulation (PRP) in patients with a high-risk proliferative diabetic retinopathy (PDR).


METHODS
This was a prospective cohort study with a two-by-two factorial design. We used full-scattered PRP to treat 115 eyes of type 2 diabetic patients who have high-risk PDR. HbA1c (A1C) and albumin levels in 24-h urine were constantly monitored during the pre-enrollment, treatment, and posttreatment periods. At a follow-up visit 12 weeks after the last PRP session, the fundus was examined for characteristics of regression from high-risk PDR and the response to PRP was determined to be successful or unsuccessful. The eyes were categorized into four groups based on average A1C levels and the presence or absence of microalbuminuria. The data were analyzed using a logistic regression model. Our statistical analysis determined the probability of achieving a satisfactory response to PRP in association with A1C levels and the presence or absence of microalbuminuria.


RESULTS
Of the 115 eyes examined, 65 (56.5%) had a successful initial response to PRP and 50 (43.5%) did not. The probability of a satisfactory response to PRP was related to A1C levels (P < 0.05) but not to microalbuminuria and its interaction with hemoglobin glycosylation (P > or = 0.05).


CONCLUSIONS
Low levels of hemoglobin glycosylation (A1C <8%) during the pretreatment, treatment, and posttreatment periods are associated with a regression of proliferative diabetic retinopathy after PRP.
Kotoula
Maria G
MG
Department of Ophthalmology, University of Thessaly School of Medicine, Larissa, Greece. tomiman@hol.gr
Koukoulis
George N
GN
Zintzaras
Elias
E
Karabatsas
Constantinos H
CH
Chatzoulis
Dimitrios Z
DZ
D000368:Aged; D000419:Albuminuria / Q000453:epidemiology / Q000378:metabolism; D015331:Cohort Studies; D003924:Diabetes Mellitus, Type 2 / Q000150:complications* / Q000453:epidemiology / Q000378:metabolism; D003928:Diabetic Nephropathies / Q000453:epidemiology / Q000378:metabolism; D003930:Diabetic Retinopathy / Q000453:epidemiology / Q000378:metabolism / Q000628:therapy*; D005260:Female; D006442:Glycated Hemoglobin / Q000378:metabolism; D006801:Humans; D006943:Hyperglycemia / Q000453:epidemiology / Q000378:metabolism / Q000628:therapy*; D008028:Light Coagulation; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012307:Risk Factors; D016896:Treatment Outcome
D006442:Glycated Hemoglobin