Rapid Fire Saturday 19 May 09:30 - 10:34 Salle Camille Blanc
D. Madeira, V. Rodrigues, M.V. Monteiro Aquino,
BRAZIL
New proposal of pan retinal photocoagulation for the treatment of proliferative diabetic retinopathy (external ring photocoagulation)
Purpose: To describe a new technique for the management of proliferative diabetic retinopathy (PDR), which involves the use of confluent photocoagulation using argon green laser, applied anteriorly, and divided into three rings. Methods: The described technique was applied to a retrospective series of ten patients. First ring: corresponds to DRS third ring, extending from the ora serrata to the mid-periphery. Second ring: corresponds to DRS second ring, extending from the mid-periphery towards vortex veins. Third ring: corresponds to DRS first ring, although it is unlikely to be done. When needed, according to the level of capillary nonperfusion, we tend to enlarge the PRP mainly on the inferior retina. The photocoagulation was performed using a three mirror lens, under topical anesthesia with an interval of 30 days in between sessions. Results: This technique successfully controlled PDR and resulted in slightly less aggressive visual field losses secondary to classic PRP. Ultrasound findings revealed posterior vitreous separation in all cases following laser treatment. Macular edema did not seem to be a clinically observed problem following external ring photocoagulation. Conclusions: Treating ischemic peripheral retina with external ring photocoagulation, central visual field and night vision would be more preserved compared to DRS technique. It may also lead to less macular edema. It is possible that, inflammation resulting from confluent burns may induce vitreous separation and consequently less posterior hyaloid adhesion.
