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Type 1 diabetes patients with severe non-proliferative retinopathy may benefit from panretinal photocoagulation.

Lövestam-Adrian, Monica; Agardh, Carl-David LU ; Torffvit, Ole LU and Agardh, Elisabet LU (2003) In Acta Ophthalmologica Scandinavica1998-01-01+01:002008-01-01+01:00 81(3). p.221-225
Abstract
Purpose: To examine whether panretinal photocoagulation for severe non-proliferative retinopathy in type 1 diabetes patients could halt the progression of retinopathy with subsequent vitreous haemorrhages and visual impairment.



Methods: During a 10-year follow-up study period of 344 type 1 diabetes patients, 81 subjects went through panretinal photocoagulation. Forty patients were treated for severe non-proliferative retinopathy (age at onset of diabetes 14 ± 8 years, diabetes duration 18 + 10 years) and 41 for proliferative retinopathy (age at onset 15 ± 10 years, diabetes duration 22 + 13 years). One randomly selected eye per patient forms the basis for the study. Metabolic control, systolic and diastolic blood... (More)
Purpose: To examine whether panretinal photocoagulation for severe non-proliferative retinopathy in type 1 diabetes patients could halt the progression of retinopathy with subsequent vitreous haemorrhages and visual impairment.



Methods: During a 10-year follow-up study period of 344 type 1 diabetes patients, 81 subjects went through panretinal photocoagulation. Forty patients were treated for severe non-proliferative retinopathy (age at onset of diabetes 14 ± 8 years, diabetes duration 18 + 10 years) and 41 for proliferative retinopathy (age at onset 15 ± 10 years, diabetes duration 22 + 13 years). One randomly selected eye per patient forms the basis for the study. Metabolic control, systolic and diastolic blood pressure, serum creatinine and urinary albumin levels were measured and analysed yearly during the follow-up period.



Results: A total of 35% (14/40) of eyes treated for severe non-proliferative retinopathy developed neovascularizations during a mean time of 2.9 ± 1.5 years. Vitreous haemorrhages were more frequent in eyes with proliferative retinopathy at treatment than in eyes with severe non-proliferative retinopathy (12/41 versus 2/40; p = 0.007). The number of vitrectomies due to vitreous haemorrhages in eyes treated for severe non-proliferative retinopathy tended to be lower (1/40 versus 6/41; p = 0.052). Before photocoagulation, visual acuity (VA) was similar in eyes with severe non-proliferative retinopathy and in those with proliferative retinopathy (1.0, 0.4-1.0 versus 1.0, 0.1-1.0; median and range). Visual impairment and blindness tended to develop more often in eyes treated for proliferative retinopathy compared to those treated for severe non-proliferative retinopathy (10/40 versus 4/40; p = 0.056). Eyes with neovascularizations at follow-up were more often visually impaired (VA < 0.5) than eyes without neovascularizations (15/55 versus 1/26; p = 0.016).



Conclusion: In type 1 diabetes, panretinal photocoagulation may be beneficial even at the severe non-proliferative retinopathy stage in terms of preventing vitreous haemorrhage, subsequent vitrectomy and visual impairment. (Less)
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organization
publishing date
type
Contribution to journal
publication status
published
subject
in
Acta Ophthalmologica Scandinavica1998-01-01+01:002008-01-01+01:00
volume
81
issue
3
pages
221 - 225
publisher
Wiley-Blackwell
external identifiers
  • wos:000183192900005
  • scopus:0038420704
ISSN
1395-3907
DOI
10.1034/j.1600-0420.2003.00050.x
language
English
LU publication?
yes
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ca5e3442-9597-4d6c-8513-54e699ad3f26 (old id 116232)
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http://www.ncbi.nlm.nih.gov/sites/entrez?Db=pubmed&Cmd=ShowDetailView&TermToSearch=12780397&ordinalpos=3&itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_RVDocSum
date added to LUP
2007-06-29 14:03:39
date last changed
2018-11-04 03:58:46
@article{ca5e3442-9597-4d6c-8513-54e699ad3f26,
  abstract     = {Purpose: To examine whether panretinal photocoagulation for severe non-proliferative retinopathy in type 1 diabetes patients could halt the progression of retinopathy with subsequent vitreous haemorrhages and visual impairment.<br/><br>
<br/><br>
Methods: During a 10-year follow-up study period of 344 type 1 diabetes patients, 81 subjects went through panretinal photocoagulation. Forty patients were treated for severe non-proliferative retinopathy (age at onset of diabetes 14 ± 8 years, diabetes duration 18 + 10 years) and 41 for proliferative retinopathy (age at onset 15 ± 10 years, diabetes duration 22 + 13 years). One randomly selected eye per patient forms the basis for the study. Metabolic control, systolic and diastolic blood pressure, serum creatinine and urinary albumin levels were measured and analysed yearly during the follow-up period.<br/><br>
<br/><br>
Results: A total of 35% (14/40) of eyes treated for severe non-proliferative retinopathy developed neovascularizations during a mean time of 2.9 ± 1.5 years. Vitreous haemorrhages were more frequent in eyes with proliferative retinopathy at treatment than in eyes with severe non-proliferative retinopathy (12/41 versus 2/40; p = 0.007). The number of vitrectomies due to vitreous haemorrhages in eyes treated for severe non-proliferative retinopathy tended to be lower (1/40 versus 6/41; p = 0.052). Before photocoagulation, visual acuity (VA) was similar in eyes with severe non-proliferative retinopathy and in those with proliferative retinopathy (1.0, 0.4-1.0 versus 1.0, 0.1-1.0; median and range). Visual impairment and blindness tended to develop more often in eyes treated for proliferative retinopathy compared to those treated for severe non-proliferative retinopathy (10/40 versus 4/40; p = 0.056). Eyes with neovascularizations at follow-up were more often visually impaired (VA &lt; 0.5) than eyes without neovascularizations (15/55 versus 1/26; p = 0.016).<br/><br>
<br/><br>
Conclusion: In type 1 diabetes, panretinal photocoagulation may be beneficial even at the severe non-proliferative retinopathy stage in terms of preventing vitreous haemorrhage, subsequent vitrectomy and visual impairment.},
  author       = {Lövestam-Adrian, Monica and Agardh, Carl-David and Torffvit, Ole and Agardh, Elisabet},
  issn         = {1395-3907},
  language     = {eng},
  number       = {3},
  pages        = {221--225},
  publisher    = {Wiley-Blackwell},
  series       = {Acta Ophthalmologica Scandinavica1998-01-01+01:002008-01-01+01:00},
  title        = {Type 1 diabetes patients with severe non-proliferative retinopathy may benefit from panretinal photocoagulation.},
  url          = {http://dx.doi.org/10.1034/j.1600-0420.2003.00050.x},
  volume       = {81},
  year         = {2003},
}