Routine, single session, indirect laser for proliferative diabetic retinopathy.
OBJECTIVE
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=0.02, chi2), 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.
Tinley
C G
CG
Department of Ophthalmology, Taunton and Somerset NHS Trust, Musgrove Park Hospital, Somerset, UK.
Gray
R H
RH
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003930:Diabetic Retinopathy / Q000503:physiopathology / Q000601:surgery*; D005260:Female; D006801:Humans; D017075:Laser Coagulation / Q000009:adverse effects / Q000379:methods*; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications; D012189:Retrospective Studies; D014792:Visual Acuity; D018630:Vitreoretinopathy, Proliferative / Q000503:physiopathology / Q000601:surgery; D055815:Young Adult