June 2020
Volume 61, Issue 7
Open Access
ARVO Annual Meeting Abstract  |   June 2020
Effectiveness of peripheral panretinal photocoagulation (PRP) performed in the operating room versus standard PRP performed in the clinic
Author Affiliations & Notes
  • Jonathan Fuerst
    Ophthalmology, The University of Alabama at Birmingham, Birmingham, Alabama, United States
  • Jason Crosson
    Ophthalmology, The University of Alabama at Birmingham, Birmingham, Alabama, United States
    Retinal Consultants of Alabama, Birmingham, Alabama, United States
  • Richard Feist
    Ophthalmology, The University of Alabama at Birmingham, Birmingham, Alabama, United States
    Retinal Consultants of Alabama, Birmingham, Alabama, United States
  • Thomas A. Swain
    Ophthalmology, The University of Alabama at Birmingham, Birmingham, Alabama, United States
  • Footnotes
    Commercial Relationships   Jonathan Fuerst, None; Jason Crosson, None; Richard Feist, None; Thomas Swain, None
  • Footnotes
    Support  None
Investigative Ophthalmology & Visual Science June 2020, Vol.61, 3718. doi:
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      Jonathan Fuerst, Jason Crosson, Richard Feist, Thomas A. Swain; Effectiveness of peripheral panretinal photocoagulation (PRP) performed in the operating room versus standard PRP performed in the clinic. Invest. Ophthalmol. Vis. Sci. 2020;61(7):3718.

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      © ARVO (1962-2015); The Authors (2016-present)

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Abstract

Purpose : Standard PRP performed in the clinic can be painful, often does not treat the anterior ischemic retina, and can lead to significant visual field loss. Peripheral PRP performed in the operating room with a laser indirect ophthalmoscope can be performed comfortably, can treat the anterior retina, and may lead to less visual field loss. This study aims to compare the effectiveness of these two methods of PRP.

Methods : This study was a retrospective cohort study comparing patients with newly diagnosed proliferative diabetic retinopathy (PDR) treated with either standard PRP or peripheral PRP. Between 2017 and 2019, 12 patients were identified that were treated with peripheral PRP, while 30 patients were identified that were treated with standard PRP. Exclusion criteria included: prior diagnosis of PDR, prior PRP, prior injections for PDR or DME, <1 follow-up visit, and standard PRP performed with the expectation of future vitrectomy. Outcome measures included: the need for additional intravitreal injections (after the initial PRP was performed), need for additional PRP treatments, subsequent operating room visits, development of vitreous hemorrhage, and change in visual acuity.

Results : There was no difference between the two PRP groups with regard to the need for additional intravitreal injections (p=0.25), need for additional PRP treatments (p=0.36), development of VH (p=0.79), or change in visual acuity (p=0.55). However, 10 of the 30 eyes in the standard PRP group required a follow-up trip to the operating room while 0 eyes in the peripheral PRP group required a subsequent trip to the operating room (p = 0.001). 50% of the eyes requiring a trip to the OR (5) had vitreous hemorrhage requiring surgery while 1 had a tractional retinal detachment.

Conclusions : This study suggests that peripheral PRP to treat the anterior ischemic retina may result in less subsequent trips to the operating room for patients. However, the method of PRP had no effect on the number of additional injections, additional PRP, development of VH, or change in visual acuity. Additional studies with larger numbers of patients would be beneficial to further evaluate these findings.

This is a 2020 ARVO Annual Meeting abstract.

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