A study on visual outcome after laser photocoagulation in diabetic retinopathy cases

Abstract

Background: Diabetic retinopathy (DR) is one of the common causes of blindness in the world. Chronic hyperglycemia in diabetes causes progressive dysfunction of the retinal vasculature (microangiopathy) causing retinal hypoxia leading to expression of „Vascular endothelial growth factor‟ (VEGF) and „neovascularization‟. Laser photocoagulation is used to convert hypoxic areas into anoxic areas thus decreasing chances of release of VEGF and hence neovascularization. Aim: To study the visual outcome after laser retinal photocoagulation in DR cases. Material and Methods: The study was carried out on 80 eyes of 44 patients presenting at Department of Ophthalmology, P. D. U. Govt. Medical College, Rajkot who had DR and underwent laser retinal photocoagulation during period of November 2012 to September 2014. All patients underwent assessment for visual acuity, anterior segment examination, posterior segment examination with +90 Dioptre lens and fundus fluorescein angiography. (FFA). Then laser retinal photocoagulation was done. After laser treatment, patients were assessed for best corrected visual acuity (BCVA) on 1week, 1 month, 3 months and 6 months and the results were analysed. Results: 80% of the patients showed improvement in BCVA, 17.5% of the patient maintained same BCVA and 2.5% patients showed deterioration in BCVA which was statistically significant (paired t-test, p<0.0001). Conclusion: Diabetic retinopathy causes significant dysfunction of retinal vasculature and hence retina, hampering vision. Timely treatment with laser retinal photocoagulation prevents further dysfunction and salvages involved retina causing statistically significant improvement in vision and quality of life. Keywords: Diabetic Retinopathy, Visual Acuity, Laser retinal photocoagulation.