470 Laser photocoagulation beneficial for proliferative diabetic retinopathy

December 30, 2015

written by Brian R McAvoy

Clinical question
How effective is laser photocoagulation for proliferative diabetic retinopathy?

Bottom line
Compared with no treatment or deferred treatment, laser photocoagulation is beneficial for treating proliferative diabetic retinopathy (PDR). Treatment with laser photocoagulation reduced the risk of severe visual loss by over 50% at 12 months, with a similar effect on the progression of PDR and the risk of vitreous haemorrhage.

There were only 5 studies. The quality of the evidence was judged to be moderate or low, reflecting the fact that 4 of the studies were conducted some time ago (1977, 1978, 1980 and 1991), when standards of trial conduct and reporting were lower; heterogeneity was also present. None of the studies reported patient-relevant outcomes, such as quality of life, pain or loss of driving licence, or adverse effects such as retinal detachment.

Laser photocoagulation is an intervention in which light energy is applied to the retina with the aim of stopping the growth and development of new blood vessels, and thereby preserving vision. It is commonly used to treat PDR.

Cochrane Systematic Review
Evans JR et al. Laser photocoagulation for proliferative diabetic retinopathy. Cochrane Reviews, 2014, Issue 11. Art. No.: CD011234.DOI: 10.1002/14651858. CD011234.pub2. This review contains 5 studies involving 4786 participants (9503 eyes).

Pearls are an independent product of the Cochrane primary care group and are meant for educational use and not to guide clinical care.