Florid diabetic retinopathy (FDR): a long-term follow-up study

Purpose: To evaluate efficacy of laser photocoagulation and pars-plana vitr ectomy in patients with FDR. Methods: Eighty-eight patients (155 eyes) with FDR were retrospectively evaluated (mean age 27 +/-6.0 years; proportion o f females 66%; insulin-dependent diabetes 100%; mean duration of diabetes 1 6.5 +/-5.8 years; poor metabolic control 83%). The eyes were divided in two groups: group I: 136 eyes amenable to laser photocoagulation and, when nec essary, to vitrectomy afterwards (45/136); group II: 19 eyes subjected dire ctly to vitrectomy. Results: In group I (mean follow-up 51.2 +/- 38.7 month s) the initial visual acuity (TVA) was 0.61 +/-0.30 and the final visual ac uity (FVA) was 0.47 +/-0.34; in the 45 vitrectomized eyes IVA was 0.15 +/-0 .24 and FVA was 0.19 +/-0.25. FDR regressed in 75% and worsened in 25% of t he cases. In group II (mean follow-up 46.4 +/- 36.3 months) IVA was 0.1 +/- 0.14 and FVA 0.14 +/-0.22. FDR regressed in 32% and worsened in 68% of case s. Conclusions: FDR remains a cause of severe visual impairment in diabetic s. Patients at risk of FDR are young females with long-standing, poorly con trolled insulin-dependent diabetes. Panretinal laser photocoagulation prior to vitrectomy is beneficial; information on this severe form of retinopath y is essential to ensure prompt diagnosis and improve its unfavorable clini cal course.