Role of Pan Retinal Photo Coagulation in The Management of Proliferative Diabetic Retinopathy

Abstract

Introduction: Diabetic retinopathy is a micro vascular complication of both type 1 and type 2 diabetes mellitus. The prevalence of DR in south India was 17.6% and the prevalence of diabetic retinopathy (DR) in patients with diabetes was recently estimated to be 34.6% in rural central India. The causes for blindness being vitreous haemorrhage, tractional retinal detachment, macular oedema, epiretinal membrane in the natural course of the disease, approximately 50% of patients with very severe NPDR (non proliferative diabetic retinopathy) progress to PDR (proliferative diabetic retinopathy) within 1 year. This study explains the role of pan retinal photo coagulation in the management of proliferative diabetic retinopathy. Objectives of this study were to study the safety of pan retinal photocoagulation in the management of proliferative diabetic retinopathy patients and to study the effect of pan retinal photocoagulation in preventing blindness in proliferative diabetic retinopathy patients. Methodology: This is an observational longitudinal study of 50 proliferative diabetic retinopathy patients who underwent pan retinal photocoagulation from May 2012 –October 2013 and were followed-up for 1 year. Results: In the first group having visual acuity (6/18 -6/24), same visual acuity was maintained in 73.3% eyes. Visual acuity increased to 6/9-6/12 in 21.53% eyes and reduced to 5/60 in 5.17% eyes due to macular edema occurring post pan retinal photo coagulation or due to an advancement of the disease itself. There was regression of neo vascularisation seen at 6 weeks follow up, in the second group having visual acuity (6/36 6/60). In the third group, 29.4% eyes bettered to 6/36-6/60 vision, whereas 70.6% eyes maintained the same baseline visual acuity of 6/60. Conclusion: Pan retinal photo coagulation is a safe and effective method to control the condition of diabetic retinopathy. Visual acuity is maintained as before and even improved after pan retinal photo coagulation at 1yr follow-up in majority of the cases.