JOURNAL OF CLINICAL AND BIOMEDICAL SCIENCES

Abstract

Objectives: To evaluate maintenance of existing vision after pan retinal photocoagulation in type II diabetes with proliferative diabetic retinopathy and to assess the causes of severe visual loss after pan retinal photocoagulation (PRP). Materials and Methods: 50 eyes of 28 patients with proliferative diabetic retinopathy (PDR) attending the retina clinic were included in this study. After detailed ocular examination and fundus fluorescein angiography, patients were treated with PRP. After PRP, visual acuity testing and retinal examination was done after 1 month, 3 months, 6 months and 1 year. Results: At baseline 30% eyes had visual acuity of 6/6- 6/9, 44% had visual acuity of 6/12-6/36 and 26% eyes had visual acuity of <6/60. 73.3% of patients with visual acuity 6/6- 6/9 at baseline retained their vision, 26.67% had decreased vision. 86.36% of patients with visual acuity 6/12- 6/36 at baseline retained their vision, 9.09% had decreased vision and 4.55% of patients had improved vision. 92.30% with poor baseline visual acuity (≤6/60) retained the same visual acuity and 7.69% of them improved to 6/9 at the end of 1 year. Causes of visual loss following PRP at the end of 1 year included vitreous hemorrhage (33.33%), pre retinal hemorrhage (33.33%), epiretinal membrane (33.33%), tractional retinal detachment (8.33%), macular edema (8%), choroidal effusion (8%), and acceleration of pre retinal fibrosis (8%). Conclusion: After PRP, visual acuity was maintained at baseline in majority of patients. However, decreased vision seen in few patients occured due to vitreous hemorrhage, pre retinal hemorrhage and macular edema.

Key words: Panretinal photocoagulation (PRP), Proliferative Diabetic Retinopathy (PDR), Early treatment diabetic retinopathy study (ETDRS), Fundus fluorescein angiography (FFA).