Evaluation of Visual Outcome in Proliferative Diabetic Retinopathy after Panretinal Photocoagulation.

Corresponding Author:
Dr. Shaeeza Samreen,
No. 27, Berlie Street,
Langford Town, Shantinagar,
Bangalore-560025, Karnataka, India.
E-mail: shaeezas@gmail.com

ABSTRACT

BACKGROUND

Several studies have reported on the visual outcome of panretinal photocoagulation (PRP). Early photocoagulation reduces the risk of severe visual loss, progression of retinopathy and the need for vitrectomy. Though vision is maintained, there are causes such as cystoid macular oedema and vitreous haemorrhage which can lead to diminished vision even after PRP. We wanted to evaluate the maintenance of existing vision after PRP for proliferative diabetic retinopathy (PDR) and assess the causes of severe visual loss after PRP.

METHODS

28 patients with PDR attending the retina clinic who fit the high risk criteria provided by ETDRS were included in this study. After assessment of visual acuity, intraocular tension, fundus examination with direct and indirect ophthalmoscopy, +90D lens, fundus fluorescein angiography (FFA), patients were treated with PRP. After PRP visual acuity testing, and retinal examination was done after 1 month, 3 months, 6 months and 1 year.

RESULTS

At baseline 30% eyes had visual acuity of 6/6-6/9, 44% had visual acuity of 6/12-6/36 and 26% eyes had visual acuity of <6/60. 73.3% of patients with visual acuity of 6/6-6/9 at baseline retained their vision, 26.67% had decreased vision. 86.36% of patients with visual acuity 6/12-6/36 at baseline retained their vision, 9.09% had decreased vision and in 4.55% vision improved. 92.30% with poor baseline visual acuity (≤ 6/60) retained the same visual acuity and 7.69% of them improved to 6/9 at the end of 1 year. Causes of visual loss following PRP at the end of 1 year included vitreous haemorrhage (33.33%), pre-retinal haemorrhage (33.33%), epiretinal membrane (33.33%), tractional retinal detachment (8.33%), macular oedema (8%), choroidal effusion (8%), and acceleration of pre-retinal fibrosis (8%).

CONCLUSIONS

After PRP visual acuity was maintained at baseline in majority of patients. However, diminution of vision can occur due to vitreous haemorrhage, pre-retinal haemorrhage and macular oedema.

KEY WORDS

Proliferative Diabetic Retinopathy (PDR), Panretinal Photocoagulation (PRP)