Results of early panretinal laser coagulation in patients with type 1 diabetes mellitus
https://doi.org/10.14341/2072-0351-6025
Abstract
Aim.
To evaluate results of panretinal laser coagulation (PLC) for severe non-proliferative and early proliferetaive diabetic retinopathy (DR) in patientswith type 1 diabetes mellitus (DM1).
Materials and methods.
58 patients with DM1 were observed. All of them were treated by panretinal laser coagulation after subtenon administrationof triamcinolone (40 mg) under ultrasonic control.
Results.
PLC at the stage of severe non-proliferative DR stabilized its development in 35% of the patients and caused its reverse development withresolution of oedema and intraretinal hemorrhage, normalization of vein diameter, and improvement of visual acuity in 30%. In 35% of these casesPLC caused neovascularization within 1.6?0.9 years after treatment. Reverse development of DR after PLC was documented in 46.3% cases withearly proliferative DR but stabilization of DR occurred rarer than in the previous group (14.6%) and hemorrhage into the vitreous body more frequently(12 cases in 41 and 2 in 40 respectively, p = 0.0007). Patients with severe non-proliferative DR tended to have reduced requirement for vitrectomyafter PLC compared with those having early proliferative DR (1 case of 40 and 6 of 41, p = 0.052).Conclusion: The above results suggest the necessity of early PLC in DM1 patients.
To evaluate results of panretinal laser coagulation (PLC) for severe non-proliferative and early proliferetaive diabetic retinopathy (DR) in patientswith type 1 diabetes mellitus (DM1).
Materials and methods.
58 patients with DM1 were observed. All of them were treated by panretinal laser coagulation after subtenon administrationof triamcinolone (40 mg) under ultrasonic control.
Results.
PLC at the stage of severe non-proliferative DR stabilized its development in 35% of the patients and caused its reverse development withresolution of oedema and intraretinal hemorrhage, normalization of vein diameter, and improvement of visual acuity in 30%. In 35% of these casesPLC caused neovascularization within 1.6?0.9 years after treatment. Reverse development of DR after PLC was documented in 46.3% cases withearly proliferative DR but stabilization of DR occurred rarer than in the previous group (14.6%) and hemorrhage into the vitreous body more frequently(12 cases in 41 and 2 in 40 respectively, p = 0.0007). Patients with severe non-proliferative DR tended to have reduced requirement for vitrectomyafter PLC compared with those having early proliferative DR (1 case of 40 and 6 of 41, p = 0.052).Conclusion: The above results suggest the necessity of early PLC in DM1 patients.
About the Authors
Dmitriy Sergeevich Atarshchikov
Endocrinological Research Centre, Moscow; Russian State Medical University, Moscow
Vladimir Yur'evich Evgrafov
Russian State Medical University, Moscow
Yury Evgen'evich Batmanov
Russian State Medical University, Moscow
References
1. Early photocoagulation for diabetic retinopathy. ETDRS report number 9. Early Treatment Diabetic Retinopathy Study Research Group // Ophthalmology. - 1991. - Vol. 98. - P. 766-785.
2. Folk J.C., Pulido J. Laser Photocoagulation of the Retina and Choroid. N.Y.: American Academy of Ophthalmology, 1997. - P. 221.
3. Frank R.N. Treating diabetic retinopathy by inhibiting growth factor pathways // Curr. Opin. Investig. Drugs. - 2009. - Vol. 10. - P. 327-335.
4. Diabetic Retinopathy Study Research Group. Photocoagulation treatment of proliferative diabetic retinopathy: The second report of Diabetic Retinopathy Study findings // Ophthalmol. - 1978. - Vol. 85. - P. 82- 106.
5. Early treatment diabetic retinopathy study group: fundus photographic risk factors for progression of diabetic retinopathy: ETDRS report №12 // Ophthalmology. - 1991. - Vol. 98. - P. 823-833.
6. Ferris E. Early photocoagulation in patients with either Type I or Type II diabetes // Trans. Am. Ophthalmol. Soc. - 1996. - Vol. 94. - P. 505- 537.
7. Diabetic Retinopathy Study Research Group Photocoagulation treatment of proliferative diabetic retinopathy: clinical applications of Diabetic Retinopathy Study (DRS) findings. DRS Report №8 // Ophthalmology. - 1981. Vol. 88. - P. 583-600.
8. Vander J.F., Duker J.S., Benson W.E., Brown G.C., McNamara J.A., Rosenstein R.B. Longterm stability and visual outcome after favourable initial response of proliferative diabetic retinopathy to panretinal photocoagulation // Ophthalmology. - 1991. - Vol. 98. - P. 1575-1579.
9. ETDRS Research Group 1999 [Early Treatment Diabetic Retinopathy Study Research Group Causes of severe visual loss in the Early Treatment Diabetic Retinopathy Study. ETDRS Report №24] // Am. J. Ophthalmol. - 1999. - Vol. 127. - P. 137-141.
10. Early Treatment Diabetic Retinopathy Study Research Group. Photocoagulation for diabetic macular edema. Early Treatment Diabetic Retinopathy Study report number 1 // Arch. Ophthalmol. - 1985. - Vol. 103. - P. 1796-1806.
11. Buckley S.A., Jenkins L., Benjamin L. Fields, DVLC and panretinal photocoagulation // Eye. - 1992. - Vol. 6. - P. 623-625.
12. Frank R.N. Visual fields and electroretinography following extensive photocoagulation // Arch. Ophthalmol. - 1975. - Vol. 93. - P. 591-596.
Review
For citations:
Atarshchikov D.S., Evgrafov V.Yu., Batmanov Yu.E. Results of early panretinal laser coagulation in patients with type 1 diabetes mellitus. Diabetes mellitus. 2010;13(1):112-115. (In Russ.) https://doi.org/10.14341/2072-0351-6025
Views:
373
This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License (CC BY-NC-ND 4.0).
Email this article 
