增殖型糖尿病性视网膜病变行全视网膜光凝后5a随访观察

目的:观察增殖型糖尿病性视网膜病变(proliferativediabetic retinopathy,PDR)行全视网膜光凝术(panretinalphotocoagulation,PRP)后5a的疗效及预后分析。方法:对92例149眼PDR患者行PRP治疗后的1,3,6,12mo进行复查,以后每6mo进行复查,并在3mo后均复查FFA,必要时补充光凝,随访5a。结果:视力提高52眼,保持不变71眼,下降26眼。5a后患者的最终矫正视力情况:≤0.01者19眼,～0.1者64眼,～0.5者58眼,>0.5者8眼。在激光后的随访期间血糖水平基本控制在正常范围内的63眼中,5a后只有6眼发生玻璃体积血、牵拉性视网膜脱离等严重并发症,占9.5%,而在血糖水平控制不满意的29眼中,有9眼(31%)发生上述情况。结论:通过早期发现、及时治疗和定期随访观察而减少糖尿病性盲是完全可能的。对于PDR患者,确诊后应立即进行PRP治疗,并制定定期随访计划,必要时应复查FFA或补充激光,同时,要向患者阐明,严格正规的内科治疗,将血糖控制在正常范围内,可有效地降低或延缓PDR发展的倾向。     

The effect of short versus long exposure times of argon laser panretinal photocoagulation on proliferative diabetic retinopathy

We performed a randomized clinical trial comparing short-duration (0.1 s) with long-duration (0.5 s) bluegreen argon laser burns to deliver panretinal photocoagulation (PRP) in eyes suffering from proliferative diabetic retinopathy with high risk characteristics. We studied 19 eyes in the 0.1-s group and 24 eyes in the 0.5-s group for 6 months. Two or more lines of acuity were lost by 20% of the 0.1-s PRP eyes, but by only 8% of the 0.5-s PRP eyes; New or increased vitreous hemorrhages occurred in 30% of the 0.1-s PRP eyes, but in only 16% of the 0.5-s PRP eyes; New or increased traction retinal detachments did not occur in the 0.1-s PRP eyes, but occurred in 16% of the 0.5-s PRP eyes. There was complete disc neovascular regression in 85% of the 0.1-s PRP eyes and 81% of the 0.5-s PRP eyes. These trends were not statistically significant.     

多点与单点激光治疗增殖性糖尿病视网膜病变的疗效比较

目的:观察577-nm多点激光用于新近诊断的增殖性糖尿病视网膜病变(proliferative diabetic retinopathy,PDR)行全视网膜光凝(panretinal photocoagulation,PRP)的疗效.方法:该前瞻性对照研究共纳入32例40眼PDR患者,随机分为2组,每组16例患者(20眼).第1组采用多点激光(pattern scan laser,PSL)行PRP治疗,第2组采用单点激光(single spot laser,SSL)治疗.所有患者在PRP治疗前与最后一次PRP治疗后3mo均行荧光素眼底血管造影检查(fundus fluorescein angiography,FFA),以判断是否存在无灌注区.激光点数、完成PRP的治疗次数、治疗时长以及患者在治疗时的疼痛程度均作为判断指标.结果:PSL组患者需3次治疗以完成PRP,而SSL组需4次完成.第1组每次治疗时间为7.3±2.3min,较第2组的时间(13.2±4.1min)明显缩短(t38=5.596,P＜0.01).第1组的治疗疼痛指数较第2组明显降低(P＜0.01).最后一次PRP治疗3mo后复查FFA,第1组有5眼(25％)出现无灌注区,而第2组有8眼(40％)出现无灌注区,需要进一步治疗.结论:多点激光用于PDR行PRP治疗较单点激光有着明显的优势.它具有效率高,治疗疼痛轻,疗效好的特点.     

Retinal function in eyes with proliferative diabetic retinopathy treated with intravitreal ranibizumab and multispot laser panretinal photocoagulation

Purpose

To compare retinal function changes in eyes with proliferative diabetic retinopathy (PDR) after intravitreal ranibizumab (IVR), combined or not with conventional (ETDRS) or multispot laser panretinal (PASCAL) photocoagulation (PRP).

Methods

This study included laser-naive PDR patients that required PRP. Eyes were randomly and prospectively assigned to receive IVR or IVR combined with PASCAL or EDTRS. PRP was performed at baseline in 1 (PASCAL) or 2 (ETDRS) sessions. In eyes with macular edema, macular short pulse grid laser was associated with IVR at baseline and IVR was repeated monthly or quarterly if neovascularization was detected on angiography. Comprehensive ophthalmological evaluations, including SD-OCT, were performed at baseline and every 4 weeks after treatment. Full-field electroretinography (ERG: extended ISCEV standard) was performed at baseline and at 12, 24 and 48 weeks.

Results

IVR?=?13, PASCAL?=?15 and ETDRS?=?15 eyes finished 48-week follow-up. There was a statistically significant BCVA improvement of 0.1–0.3 logMAR in all groups, and fluorescein angiography leakage area (FLA) reduced in 56%, 73%, and 73% from baseline for ETDRS, IVR and PASCAL, respectively, up to 48 weeks without significant differences between groups (p?>?0.05). A significant a- and b-wave amplitudes reduction was observed for dark- and light-adapted ERG for ETDRS and PASCAL, but only minor dark-adapted b-wave reduction was found for IVR, up to 48 weeks. As an example, at week 48, combined response b-wave amplitude reduced in 181.5?±?31.4 µV, 128.0?±?27.9 µV and 82.4?±?15.2 µV for ETDRS, PASCAL and IVR (p?<?0.05 each group), respectively. No significant difference was observed between ETDRS and PASCAL for any ERG parameter.

Conclusions

IVR combined with single or multiple spot PRP causes similar retinal function impairment during 48 weeks of observation, while IVR alone seems to be similarly effective controlling FLA without changing retinal function.

     

Single versus multiple treatment sessions of argon laser panretinal photocoagulation for proliferative diabetic retinopathy

A prospective, randomized study was performed to demonstrate whether there was a difference in the beneficial or adverse effects of argon laser photocoagulation for proliferative diabetic retinopathy depending on whether treatment was administered in a single session as compared with multiple sessions spaced over time. Results show no major differences between groups in the effect of treatment on visual acuity, visual field scores, or retinopathy risk factors. Exudative retinal detachment, choroidal detachment, and angle closure occurred more commonly in single session treatment group eyes, but these effects were transient, and no long-term difference between treatment groups was found.     

Light panretinal photocoagulation (LPRP) versus classic panretinal photocoagulation (CPRP) in proliferative diabetic retinopathy

Purpose. We misled to verify whether a panretinal photocoagulation (PRP) performed using low levels of ARGON laser energy (light PRP) has the same efficacy as a PRP performed in a conventional fashion using argon green wavelengths (classic PRP) in eyes with high-risk proliferative diabetic retinopathy (HRPDR). Furthermore, we misled to compare the session number performed and the side effects produced by the two techniques. Methods. Sixty-five eyes with HRPDR of 50 consecutive patients were enrolled in a prospective randomized controlled trial. In eyes selected for light PRP, a very light biomicroscopic effect on the retina was obtained for each spot. In eyes assigned to classic PRP, each spot produced a white-yellow biomicroscopic effect. Mean follow-up was 22.4 months ±9.7 in the light PRP and 21.6 months ±9.3 in the classic PRP group (p = 0.727). Results. The initial mean logMAR visual acuity (VA) in the light PRP group was 0.12 ± 0.13 and in the classic PRP group 0.14 ± 0.15 (p = 0.493). The final mean VA in the former was 0.18 ± 0.25, and in the latter 0.27 ± 0.30 (p = 0.231). Median power was 235 mW (100–540 mW) for light and 420 mW (200–950 mW) for classic PRP (p &lt; 0.001). Regression of HRPDR at the end of the follow-up was obtained in 30/31 eyes (97%) treated with classic PRP and in 31/34 eyes (91%) treated with light PRP (p = 0.615). The total mean session number was 7.4 ± 2.4 for light and 9.9 ± 2.2 for the classic PRP group (p &lt; 0.001). Complications were more frequent in the classic PRP group. Conclusions. The efficacy of Light PRP is similar to that of classic Light PRP in eyes with HRPDR. Light PRP is associated with fewer complications and allows the reduction of the number of treatment sessions.     

Panretinal photocoagulation versus panretinal photocoagulation plus intravitreal bevacizumab for high-risk proliferative diabetic retinopathy

AIM: To evaluate the effects of panretinal photocoagulation (PRP) compared with PRP plus intravitreal bevacizumab (IVB) in patients with high-risk proliferative diabetic retinopathy (PDR) according to the Early Treatment Diabetic Retinopathy Study criteria. METHODS: The data were collected retrospectively from the eyes of high-risk PDR patients, which were divided into two groups. After treated with standard PRP, the eyes were randomly assigned to receive only PRP (PRP group) or PRP plus intravitreal injection of 1.25 mg of bevacizumab (PRP-Plus group). Patients underwent complete ophthalmic evaluation, including best corrected visual acuity (BCVA), intraocular pressure (IOP), and new vessel size in fluorescein angiography (FA) and optical coherence tomography for the assessment of central subfield macular thickness (CSMT) at baseline and at weeks 12 (±2), 16 (±2), 24 (±2) and 48 (±2). Main outcome measures also included vitreous clear-up time and neovascularization on the disc (NVD) regression time. Adverse events associated with intravitreal injection were investigated. RESULTS: Thirty consecutive patients (n=36 eyes) completed the 48-week follow-up. There was no significant difference between the PRP and PRP-Plus groups with respect to age, gender, type or duration of diabetes, area of fluorescein leakage from active neovascularizations (NVs), BCVA or CSMT at baseline. The mean vitreous clear-up time was 12.1±3.4wk after PRP and 8.4±3.5wk after PRP combined with IVB. The mean time interval from treatment to complete NVD regression on FA examination was 15.2±3.5wk in PRP group and 12.5±3.1wk in PRP-Plus group. No significant difference in CSMT was observed between the groups throughout the study period. However, the total area of actively leaking NVs was significantly reduced in the PRP-Plus group compared with the PRP group (P<0.05). Patients received an average of 1.3 injections (range: 1-2). Ten eyes (27.8%) underwent 2 injections. Two eyes had ocular complication of PDR progression to dense vitreous hemorrhage (VH). No major adverse events were identified. CONCLUSION: The adjunctive use of IVB with PRP is associated with a greater reduction in the area of active leaking NVs than PRP alone in patients with high-risk PDR. Short-term results suggest combined IVB and PRP achieved rapid clearance of VH and regression of retinal NV in the treatment of high-risk PDR. Further studies are needed to determine the effect of repeated intravitreal bevacizumab injections and the proper number of bevacizumab injections as an adjuvant.     

Light panretinal photocoagulation (LPRP) versus classic panretinal photocoagulation (CPRP) in proliferative diabetic retinopathy

PURPOSE: We misled to verify whether a panretinal photocoagulation (PRP) performed using low levels of ARGON laser energy (light PRP) has the same efficacy as a PRP performed in a conventional fashion using argon green wavelengths (classic PRP) in eyes with high-risk proliferative diabetic retinopathy (HRPDR). Furthermore, we misled to compare the session number performed and the side effects produced by the two techniques. METHODS: Sixty-five eyes with HRPDR of 50 consecutive patients were enrolled in a prospective randomized controlled trial. In eyes selected for light PRP, a very light biomicroscopic effect on the retina was obtained for each spot. In eyes assigned to classic PRP, each spot produced a white-yellow biomicroscopic effect. Mean follow-up was 22.4 months +/- 9.7 in the light PRP and 21.6 months +/- 9.3 in the classic PRP group (p = 0.727). RESULTS: The initial mean logMAR visual acuity (VA) in the light PRP group was 0.12 +/- 0.13 and in the classic PRP group 0.14 +/- 0.15 (p = 0.493). The final mean VA in the former was 0.18 +/- 0.25, and in the latter 0.27 +/- 0.30 (p = 0.231). Median power was 235mW (100-540mW) for light and 420mW (200-950mW) for classic PRP (p < 0.001). Regression of HRPDR at the end of the follow-up was obtained in 30/31 eyes (97%) treated with classic PRP and in 31/34 eyes (91%) treated with light PRP (p = 0.615). The total mean session number was 7.4 +/- 2.4 for light and 9.9 +/- 2.2 for the classic PRP group (p < 0.001). Complications were more frequent in the classic PRP group. CONCLUSIONS: The efficacy of Light PRP is similar to that of classic Light PRP in eyes with HRPDR. Light PRP is associated with fewer complications and allows the reduction of the number of treatment sessions.     

Retinopathy risk factor regression after laser panretinal photocoagulation for proliferative diabetic retinopathy

Fifty eyes of patients with proliferative diabetic retinopathy were followed at frequent intervals to determine the rapidity and stability of retinopathy risk factor regression after argon laser panretinal photocoagulation. Retinopathy risk factors regress rapidly after laser photocoagulation. The incidence of eyes at high risk for severe visual loss (eyes with 3 or more retinopathy risk factors) decreased from 100% prior to treatment to 28% three weeks after treatment. The early response to treatment was a good prognostic indicator of longer term results. Seventy-two percent of eyes which improved from a high- to a low-risk category by three weeks continued to remain at low risk at six months. Sixty-four percent of eyes which failed to improve to a low-risk category by three weeks continued to remain at high risk at six months. The early response to laser panretinal ablation may be used to predict longer-term results.     

One-year outcomes of panretinal photocoagulation in proliferative diabetic retinopathy

PURPOSE: To describe the clinical features and complications of diabetic retinopathy, visual acuity, and number of repeat treatments after panretinal photocoagulation for proliferative diabetic retinopathy in a tertiary care center. METHODS: A cohort study was conducted with data collection from medical records of patients undergoing panretinal photocoagulation between 1985 and 1995 at the Scheie Eye Institute; 297 eyes of 186 patients were eligible for study. RESULTS: The presence of neovascularization of the disk at baseline, an earlier onset of diabetes, and a shorter duration of disease before panretinal photocoagulation were the strongest risk factors for needing an additional panretinal photocoagulation treatment. Sixty-two percent of eyes with poor visual acuity (< or =20/200) at baseline still had poor visual acuity at 1 year, and 76% with good visual acuity (> or =20/40) at baseline maintained good visual acuity at 1 year. Poor vision at baseline was the only risk factor for having poor vision at 1 year. Vitreous hemorrhage was present in 44% of eyes at baseline. New vitreous hemorrhage developed in 37% of eyes during the first year after panretinal photocoagulation. A traction retinal detachment was present in 4% of eyes at baseline and newly developed in 6% of eyes during follow-up. A repeat panretinal photocoagulation treatment was performed in 39% of eyes after initial treatment. A vitrectomy was performed in 10% of eyes from baseline through the 1-year follow-up visit. CONCLUSIONS: The data from this study are useful for counseling patients with respect to likely visual outcome, possibility of major complications from proliferative diabetic retinopathy, and the chance of undergoing additional laser treatment after panretinal photocoagulation.     

Severe proliferative diabetic retinopathy treated with vitrectomy or panretinal photocoagulation: a monocenter randomized controlled clinical trial

Objective

Visual and anatomic results of pars plana vitrectomy were compared with panretinal photocoagulation in cases of severe proliferative diabetic retinopathy.

Design

Monocenter randomized controlled clinical trial; randomization and allocation to trial group were carried out by a central computer system.

Participants

We studied 180 eyes of 180 patients with severe proliferative diabetic retinopathy, half with tractional retinal detachment not involving the macula (n = 90). Some were treated by pars plana vitrectomy (n = 90) and some by panretinal photocoagulation (n = 90).

Methods

Eyes were randomly divided into 2 groups. Group 1 was treated with pars plana vitrectomy, membrane and internal limited membrane peeling, panretinal photocoagulation, and focal or grid macular laser. Group 2 was treated with panretinal photocoagulation and focal or grid macular laser. Follow-up was at least 12 months.

Results

Mean preoperative visual acuities and ophthalmic fundus characteristics were compared across groups. A year postoperation, visual acuity (the primary endpoint) in group 1 improved in 30 eyes (33%); was unchanged in 22 eyes (25%); and decreased in 38 eyes (42%). In group 2, visual acuity improved in 32 eyes (35%); was unchanged in 42 eyes (47%); and decreased in 16 eyes (18%). The percentage of improvement in the 2 groups was not statistically significant (p = 0.75), whereas the stabilized (p = 0.002) and worsened eyes (p = 0.0003) in group 1 and group 2 were significantly different.

Conclusion

In cases of severe proliferative diabetic retinopathy, even with tractional retinal detachment not involving macula, it is best to defer vitrectomy unless definite progression that threatens the vascular center is documented.     

Incremental panretinal photocoagulation. Results in treating proliferative diabetic retinopathy

Since 1977, the author has treated proliferative diabetic retinopathy (PDR) under a protocol using DRS-style panretinal photocoagulation (PRP), with supplemental PRP, panretinal cryotherapy, and vitrectomy as needed. A total of 55 eyes (33 patients) were started on this protocol between 1/1/77 and 4/30/82. Follow-up averages 33 months (range: 12-80 months). Forty-nine eyes (89%) required PRP only; two eyes received panretinal cryotherapy, and four had vitrectomies. Visual acuity was maintained or improved in 44 eyes (80%); 48 eyes (87%) retained visual acuity of 20/100 or better. The major cause of visual loss was diabetic maculopathy.     

Diode laser scatter photocoagulation in diabetic retinopathy

The efficacy of scatter photocoagulation therapy for diabetic retinopathy using the diode laser was compared with that of the argon green laser in a prospective randomized trial involving 50 eyes. Six months after treatment, neovascularization regressed in 16 eyes (64%) in the diode group and 18 eyes (72%) in the argon group. Diode laser appears to be a suitable alternative to argon green laser for scatter photocoagulation in diabetic retinopathy.     

贝伐单抗联合全视网膜光凝治疗增生型糖尿病视网膜病变的疗效观察

目的　检测贝伐单抗玻璃体内注射疗法（ｂｅｖａｃｉｚｕｍａｂｉｎｊｅｃｔｉｏｎｓｉｎｖｉｔｒｅｏｕｓ,ＩＶＢ）对增生型糖尿病视网膜病变（ｐｒｏｌｉｆｅｒａ-ｔｉｖｅｄｉａｂｅｔｉｃｒｅｔｉｎｏｐａｔｈｙ,ＰＤＲ）中视网膜新生血管（ｒｅｔｉｎａｌｎｅｏｖａｓｃｕｌａｒｉｚａｔｉｏｎ,ＲＮＶ）的消退作用;评估ＩＶＢ联合全视网膜光凝（ｐａｎ-ｒｅｎｔｉｎａｌｐｈｏｔｏｃｏａｇｕｌａｔｉｏｎ,ＰＲＰ）对ＰＤＲ的临床疗效和安全性。方法　本研究收集行ＰＲＰ的ＰＤＲ患者７２例（７２眼）,根据术前是否ＩＶＢ分为注射组和对照组,注射组在完成ＩＶＢ１．２５ｍｇ后第７天行眼底荧光血管造影（ｆｕｎｄｕｓｆｌｕｏｒｅｓｃｅｉｎａｎｇｉｏｇｒａｐｈｙ,ＦＦＡ）检查,并于当天开始第一个象限的ＰＲＰ,每周１次,共４次完成ＰＲＰ;对照组每周１次,共４次完成ＰＲＰ。两组患者均于ＰＲＰ后４周、８周、１２周复诊,并复查最佳矫正视力（ｂｅｓｔｃｏｒｒｅｃｔｅｄｖｉｓｕａｌａｃｕｉｔｙ,ＢＣＶＡ）、眼压、ＦＦＡ、光学相干断层扫描、眼前节及眼底。结果　注射组ＩＶＢ后１周,ＢＣＶＡ提高,ＲＮＶ渗漏面积减少,与治疗前差异有统计学意义（Ｐ＜０．０５）;注射组各时间点ＢＣＶＡ、ＲＮＶ消退情况均显著优于对照组（均为Ｐ＜０．０５）。注射组各时间点黄斑中心凹视网膜厚度均较治疗前显著下降（均为Ｐ＜０．０５）,对照组各时间点黄斑中心凹视网膜厚度均较治疗前显著降低（均为Ｐ＜０．０５）,两组之间各时间点比较,差异均无统计学意义（均为Ｐ＞０．０５）。结论　ＰＲＰ能延迟单纯ＩＶＢ后ＲＮＶ的复发;联合治疗可更有效地推动ＰＤＲ中ＲＮＶ消退,安全可靠,可以更好地保护患者的视觉功能。     

A clinical comparison of central and peripheral argon laser panretinal photocoagulation for proliferative diabetic retinopathy

Fifty eyes with three or four diabetic retinopathy risk factors received argon laser panretinal photocoagulation (PRP) with treatment randomly assigned to either central or peripheral distribution. Six months after treatment, two or more acuity lines had been lost by 24% of the central PRP, and by only 8% of the peripheral PRP eyes. Mean visual field constriction with the I-4e isopter was 39% for the central and 29% for the peripheral PRP eyes; for the IV-4e isopter, it was 12 and 7%. Pretreatment macular thickening increased in 19% of the central PRP eyes, but decreased in 19% of the peripheral PRP eyes (P less than 0.05). There was complete disc neovascular regression in 38% of the central and 47% of the peripheral PRP eyes. Partial regression was obtained in 31% centrally and 33% peripherally treated eyes.     

The clinical significance of venous filling time through panretinal photocoagulation in proliferative diabetic retinopathy

PURPOSE: To verify the clinical correlation between retinopathy progression and the change of venous filling time (VFT), measured before and after panretinal photocoagulation (PRP), in proliferative diabetic retinopathy (PDR) patients. METHODS: We conducted this study on 32 patients (32 eyes) who received PRP for PDR. These patients were subdivided into two groups in accordance with the clinical course of PRP: the stabilized group in which retinal neovascularization was regressed and the progressed group in which retinal neovascularization was continued and a complication, such as vitreous hemorrhage or tractional retinal detachment, was developed within 12 months of laser treatment. Arteriovenous passage time (AVP) and VFT were measured by video fluorescein angiogram (FAG) using scanning laser ophthalmoscope (SLO) before and after PRP. VFT values were assigned by measuring by the time duration from start of venous lamina flow to the fullness of fluorescence on the vascular arch. RESULTS: In the stabilized group, AVP was decreased by 0.20 +/- 0.89 sec and VFT was decreased by 0.30 +/- 1.69 sec through PRP. In the progressed group, AVP was increased in 0.12 +/- 1.22 sec and VFT was increased by 0.99 +/- 1.60 sec through PRP. In both groups, the VFT changes were significant (P=0.04) but the AVP changes were not (P=0.34). CONCLUSIONS: VFT was significantly decreased in the stabilized group and significantly increased in the progressed group after PRP. Accordingly, we suggest that VFT changes after PRP can be utilized as a prognostic indicator for evaluating clinical course of diabetic retinopathy after performing PRP and for monitoring the clinical effect of PRP.     

Reduction of severe macular edema in eyes with poor vision after panretinal photocoagulation for proliferative diabetic retinopathy

Currently available data from multicenter randomized trials on laser treatment of diabetic macular edema refer only to eyes with pretreatment visual acuities of 20/160 or better. After observing reduction of more severe macular edema and visual improvement following panretinal photocoagulation (PRP) alone in some patients, we reviewed our experience with this problem. In 18 eyes of 14 patients with proliferative diabetic retinopathy and visual acuity of 20/200 or worse, secondary to severe macular edema were identified. At 6 months after PRP without focal macular laser treatment, macular edema was reduced in 13 eyes, 8 of which improved by 2 lines of vision. Among the latter 8 eyes, the visual acuity of 4 recovered to 20/80 or better; the remaining 10 eyes, which had chronic retinal pigment epithelial atrophy or extensive macular ischemia, did not improve. Based on these observations, we suggest that peripheral PRP performed in multiple sessions over several months may have a beneficial effect on severe macular edema in some eyes with adequate macular perfusion.     

Encircling panretinal laser photocoagulation may prevent macular detachment after vitrectomy for proliferative diabetic retinopathy

Macular detachment due to peripheral retinal tears that occur after pars plana vitrectomy for proliferative diabetic retinopathy can result in severe visual loss despite successful retinal reattachment. The authors reviewed the records of three patients who developed peripheral sclerotomy-related rhegmatogenous retinal detachments one to six months after vitrectomy for proliferative diabetic retinopathy, despite the absence of detectable sclerotomyrelated retinal tears by indirect ophthalmoscopy and scleral depression at the conclusion of surgery. All three patients had received standard panretinal laser photocoagulation in a complete encircling pattern either prior to or during the initial vitrectomy. Clinically or echographically, each patient was seen to have a partial or complete annual peripheral sclerotomy-related rhegmatogenous retinal detachment delimited to the equator. In each of these three cases, posterior extension of the peripheral retinal detachment into the macular area was prevented by the most anterior row of the photocoagulation scars. Standard panretinal laser photocoagulation applied in a complete encircling pattern may be useful in the prophylaxis of macular detachment from sclerotomy-related retinal tears that occur after vitrectomy for proliferative diabetic retinopathy.