Delivery of photocoagulation treatment for diabetic retinopathy at a large Australian ophthalmic hospital: comparisons with national clinical practice guidelines.

Abstract

To determine if the delivery of photocoagulation for diabetic retinopathy at a large Australian ophthalmic hospital conforms with Australian National Health and Medical Research Council clinical practice guidelines. A retrospective medical record review was conducted of all patients who had initial laser treatment for diabetic retinopathy at the Royal Victorian Eye and Ear Hospital from January 1997 to December 1998. The study included 322 eyes from 203 patients. The mean age was 65.8 years (range 18-89 years) and the mean duration of diabetes was 14.7 years (range 1-40 years). Panretinal photocoagulation (PRP) alone was performed in 37 eyes over a mean number of 2.6 sessions. The median waiting time for these procedures was 14 days (range 0-146 days) and the median follow-up time was 7.1 weeks (range 1-25 weeks). Focal treatment was performed (without PRP) in 238 eyes and 55.5% of these cases required repeat focal treatment for persistent clinically significant macular oedema. Median waiting time for focal treatment was 20 days (range 0-302 days) and the median follow-up time after treatment was 12.1 weeks (range 1.7-42.0 weeks). Focal and PRP treatment was used in 47 eyes that had maculopathy concurrently with proliferative retinopathy. Focal treatment was applied before (or at the same session as) the PRP wherever possible. The study indicates that the application of photocoagulation and follow up for diabetic retinopathy at this tertiary referral institution conforms closely with Australian clinical practice guidelines.