Abstract
Argon laser panretinal photocoagulation for proliferative diabetic retinopathy was shown in the Diabetic Retinopathy Study and Early Treatment Diabetic Retinopathy Study to reduce the incidence of blindness by 50% with relatively small amounts of treatment. However, some diabetics require much more extensive photocoagulation for control of proliferative disease. We attempted to determine risk factors for poor response to treatment with panretinal photocoagulation (PRP) by studying outcome in relation to the argon laser burn count and the presence of diabetic vascular complications. Sixty-six consecutively treated eyes undergoing PRP were studied, of which 57% showed resolution of new vessels 6 weeks after treatment. This was significantly related to the total amount of laser treatment given (mean no. in regressed eyes 5800 burns, non-regressed 3510 burns; p<0.05). Renal disease and age (<50 years) were identified as risk factors for non-regression (p<0.05); hypertension, neuropathy, duration of disease and insulin dependence had no significant effect on outcome. We conclude that regression of proliferative disease is significantly related to the cumulative total number of laser burns applied and that successful laser photocoagulation in patients with diabetic renal disease requires considerably more treatment than that suggested by earlier studies.
Similar content being viewed by others
Article PDF
References
Ulbig M . Hamilton A. Factors influencing the natural history of diabetic retinopathy. Eye 1993; 7: 242–9.
Office of Population Census and Surveys. Causes of blindness and partial sight in England and Wales 1990–1991. Studies on medical and population subjects no. 57. London: HMSO, 1995:13570th edn.
Beetham W . Visual prognosis of proliferating diabetic retinopathy. Br J Ophthalmol 1963; 47: 611–9.
Diabetic Retinopathy Study Research Group. Photo-coagulation treatment of proliferative diabetic retinopathy: clinical application of diabetic retinopathy study (DRS) findings. DRS report no. 8. Ophthalmology 1981; 88: 583–600.
Diabetic Retinopathy Study Research Group. Four risk factors for severe visual loss in diabetic retinopathy: the third report from the diabetic retinopathy study. Arch Ophthalmol 1979; 97: 654–5.
Early Treatment Diabetic Retinopathy Study Research Group. Early treatment diabetic retinopathy study design and baseline patient characteristics. ETDRS report no. 7. Ophthalmology 1991; 98: 741–56.
Early Treatment Diabetic Retinopathy Study Research Group. Early photocoagulation for diabetic retinopathy. ETDRS report no. 9. Ophthalmology 1991; 98: 766–85.
Aylward GW, Pearson RV, Jagger JD, Hamilton AM . Extensive argon laser photocoagulation in the treatment of proliferative diabetic retinopathy. Br J Ophthalmol 1989; 73: 197–201.
Vine AK . The efficacy of additional argon laser photocoagulation for persistent, severe proliferative diabetic retinopathy. Ophthalmology 1985; 92: 1532–7.
Doft B, Metz D, Kelsey S . Augmentation laser for proliferative diabetic retinopathy that fails to respond to initial panretinal photocoagulation. Ophthalmology 1992; 99: 1728–35.
Reddy VM, Zamora RL, Olk RJ . Quantitation of retinal ablation in proliferative diabetic retinopathy. Am J Ophthalmol 1995; 119: 760–6.
The Diabetes Control and Complications Research Group. The effect of intensive treatment of diabetes on the development and progression of longterm complications in insulin-dependent diabetes mellitus. N Engl J Med 1993; 329: 977–86.
Knowler W, Bennett P, Ballintine E . Increased incidence of retinopathy in diabetics with elevated blood pressure: a six-year follow-up study of Pima Indians. N Engl J Med 1980; 302: 645–50.
Ulbig M, Kampik A, Thurau S, Land W . Long-term follow-up of diabetic retinopathy for up to 71 months after combined renal and pancreatic transplantation. Graefes Arch Clin Exp Ophthalmol 1991; 229: 242–5.
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Cordeiro, M., Stanford, M., Phillips, P. et al. Relationship of diabetic microvascular complications to outcome in panretinal photocoagulation treatment of proliferative diabetic retinopathy. Eye 11, 531–536 (1997). https://doi.org/10.1038/eye.1997.139
Issue Date:
DOI: https://doi.org/10.1038/eye.1997.139
Keywords
This article is cited by
-
Proliferative diabetic retinopathy without preoperative pan-retinal photocoagulation is associated with higher levels of intravitreal IL-6 and postoperative inflammation
International Journal of Retina and Vitreous (2020)
-
Clinical applications of the MicroPulse diode laser
Eye (1999)
-
Letter
Eye (1998)