One-year outcomes of panretinal photocoagulation in proliferative diabeticretinopathy

PURPOSE: To describe the clinical features and complications of diabetic re tinopathy, visual acuity, and number of repeat treatments after panretinal photocoagulation for proliferative diabetic retinopathy in a tertiary care center. METHODS: A cohort study was conducted with data collection from medical rec ords of patients undergoing panretinal photocoagulation between 1985 and 19 95 at the Scheie Eye Institute; 297 eyes of 186 patients were eligible for study. RESULTS: The presence of neovascularization of the disk at baseline, an ear lier onset of diabetes, and a shorter duration of disease before panretinal photocoagulation were the strongest risk factors for needing an additional panretinal photocoagulation treatment. Sixty-two percent of eyes with poor visual acuity (less than or equal to 20/200) at baseline still had poor vi sual acuity at 1 year, and 76% with good visual acuity (greater than or equ al to 20/40) at baseline maintained good visual acuity at 1 year. Poor visi on at baseline was the only risk factor for having poor vision at 1 year. V itreous hemorrhage was present in 44% of eyes at baseline. New vitreous hem orrhage developed in 37% of eyes during the first year after panretinal pho tocoagulation. A traction retinal detachment was present in 4% of eyes at b aseline and newly developed in 6% of eyes during follow-up. A repeat panret inal photocoagulation treatment was performed in 39% of eyes after initial treatment. A vitrectomy was performed in 10% of eyes from baseline through the 1-year follow-up visit. CONCLUSIONS: The data from this study are useful for counseling patients wi th respect to likely visual outcome, possibility of major complications fro m proliferative diabetic retinopathy, and the chance of undergoing addition al laser treatment after panretinal photocoagulation. (Am J Ophthalmol 2000 ;129:178-185. (C) 2000 by Elsevier Science Inc. All rights reserved.)