Guidelines for treating proliferative diabetic retinopathy

This article published in the Oct. 20 issue of The New England Journal of Medicine provides an excellent summary of preferred practice patterns for managing patients with proliferative diabetic retinopathy (PDR). The authors, led by Neil M Bressler, MD, discuss details on when and how to treat the condition and complications of treatment.

They review the pathophysiology of PDR, as well as the effects of therapy with panretinal photocoagulation (PRP). They also discuss the findings of randomized clinical trials that have evaluated the efficacy of PRP for PDR.

The authors provide an overview of guidelines and standard practices for performing PRP and for advising patients regarding the side effects of treatment and follow-up visits. They review the adverse effects of PRP, focusing on the most common complication, exacerbation of macular edema.

They also address other therapies being investigated for the treatment of PDR, such as anti-VEGF therapy, and conclude with recommendations for treating a patient featured in the article's case vignette.