Definition and Indications
Panretinal photocoagulation involves using a laser (photocoagulator) to place laser spots in the peripheral retina for 360 degrees sparing the center of the retina. The central vision is in the macula which is roughly the center 20 degrees of the retina. Most panretinal photocoagulation treatments spare the center 30 degrees of the retina.
Panretinal photocoagulation (PRP) is used primarily for patients with proliferative diabetic retinopathy. It is also effective at reducing the risk of vision loss in patients with occlusive retinopathies like central retinal vein occlusion, branch retinal vein occlusion, sickle retinopathy, Eales disease and IRVAN (idiopathic retinal vasculitis, aneurysms, and neuroretinitis).
How it works
Panretinal laser, by destroying peripheral retinal cells that are releasing VEGF, decreases the amount of VEGF inside the eye. This not only protects the eye from the formation of new vessels, it also causes regression of already formed new vessels.
Benefit of PRP
Risk of PRP
Panretinal laser is a lot of laser. Most eyes need between 1000 and 3000 laser spots to suppress neovascularization. That much laser has some side effects:
- Pain during treatment
- Loss of accommodation (near vision) requiring stronger reading glasses
- Mild pupillary dilation
- Minimal peripheral vision loss