Abstract
Purpose :
Proliferative diabetic retinopathy (PDR) is characterized by formation of new, fragile blood vessels that can bleed and obscure vision. It is commonly treated with pan-retinal photocoagulation (PRP) to reduce the risk of severe vision loss. However, PRP often impairs peripheral and central visual field function. The purpose of this study is to investigate the natural course of visual function in patients who had regressed PDR after PRP.
Methods :
We recalled 22 diabetic participants who had previously undergone PRP (1-32 years ago) and 11 age-matched controls for repeat evaluation 4-5 years after baseline evaluation. The PRP had been performed, on average, 18.4 (range: 1-32) years previously. Tests included Pelli Robson contrast sensitivity, quick Contrast Sensitivity Function, Minnesota reading test, Frequency Doubling Technology 24-2 program, Humphrey Field Analyzer 10-2 and 60-4 program, photostress, and dark adaptation, along with the National Eye Institute Visual Function Questionnaire (NEI VFQ)-25 and the Low Luminance Questionnaire (LLQ). Data analysis was performed using SPSS. Independent and dependent t-tests were used to compared between groups and between two time points.
Results :
At the follow-up visit, the diabetic group performed worse than the control group in all visual function tests and questionnaires, showing impairment in central and peripheral vision, and lower quality of life. However, the diabetic group who had received PRP showed no significant decline in any major vision and quality of life parameters when adjusted for the effect of aging.
Conclusions :
This natural history study demonstrates that, even many years after PRP treatment, PDR patients can have stable visual function with mild deterioration over time, possibly associated with aging. This is the first longitudinal study that assessed visual function in patients years after laser treatment for PDR. These findings may help to design future clinical trials to improve vision in persons who have received PRP for PDR.
This abstract was presented at the 2019 ARVO Annual Meeting, held in Vancouver, Canada, April 28 - May 2, 2019.