Retinal cryotherapy in diabetic vitreous hemorrhage

Abstract

Background: To evaluate the role of cryotherapy of anterior retina in preventing vitreous hemorrhage in patients with proliferative diabetic retinopathy (PDR). Materials and Methods: The patients were divided into two groups: (1) retinal cryotherapy without sufficient retinal laser treatment and (2) anterior peripheral retinal cryotherapy (ARC) in addition to sufficient panretinal laser treatment. The history and management of vitreous hemorrhage were recorded. Ocular examination and fluorescein angiographic findings for recovery of vision and presence of recurrent vitreous hemorrhage and neovascularization in the two groups were compared to determine the effectiveness of adjunct cryotherapy in PDR. Results:The rate of clearance of vitreous hemorrhage in groups 1 and 2 was 11 out of 13 (85%) and 15 out of 17 (88%), respectively (P = 0.717). In patients with cleared vitreous, the complete regression rate of neovacularization in groups 1 and 2 was 2 out of 11 (18%) and 8 out of 15 (53%), respectively (P < 0.05). Frequencies of the neovascular categories at different ocular sites in each group were similar, and no statistically significant difference was found (group 1, P = 0.884; group 2, P = 0.43). Comparison of corrected visual acuity on the last follow-up to corrected visual acuity before ARC gave the following results: 19 eyes had improved visual acuity of at least two lines, and visual recovery had similar distributions (group 1, P = 0.05; group 2, P = 0.085). Conclusions:It seems that ARC combined with photocoagulation might be a helpful adjunct procedure in PDR and to prevent recurrent vitreous hemorrhage.