Multicenter randomized clinical trial of retinal photocoagulation for preproliferative diabetic retinopathy.
OBJECTIVE
To evaluate the effectiveness of selective photocoagulation (S-PC) for nonperfusion areas (NPA) in preproliferative diabetic retinopathy (PPDR).


METHODS
A multicenter randomized controlled clinical trial of 69 patients with PPDR showing NPA comparable to or larger than those on reference photographs.                         The patients were assigned to 2 groups; one was treated with S-PC (PC group: 32 patients), while the other did not receive S-PS (non-PC group: 37 patients). In the non-PC group, panretinal photocoagulation (PRP) was performed whenever proliferative diabetic retinopathy (PDR) developed. In the PC group, S-PC of the NPA was performed followed by additional coagulation whenever the NPA extended, and PRP was performed whenever PDR developed. The primary outcome was the development of PDR.


RESULTS
During the entire course, PDR developed in 18 (26%) of the 69 patients. The incidence was significantly higher in the non-PC group than in the PC group. Comparison of the visual acuity at the time of registration and after 36 months showed no significant differences between the two groups.


CONCLUSIONS
S-PC for NPA in PPDR is effective at preventing PDR development.
Yukihiro
Y
Sato
Noriko
N
Kojimahara
Shigehiko
S
Kitano
Satoshi
S
Kato
Noburo
N
Ando
Naohito
N
Yamaguchi
Sadao
S
Hori
D003930:Diabetic Retinopathy / Q000209:etiology / Q000517:prevention & control* / Q000601:surgery; D018450:Disease Progression; D005260:Female; D005451:Fluorescein Angiography; D006801:Humans; D015994:Incidence; D017075:Laser Coagulation; D008297:Male; D008875:Middle Aged; D012160:Retina / Q000601:surgery*; D016896:Treatment Outcome; D014792:Visual Acuity / Q000502:physiology