Disclaimer
is Guideline attempts to define principles of practice that should produce high-quality patient
care. It is applicable to specialists, primary care, and providers at all levels. is Guideline
should not be considered exclusive of other methods of care reasonably directed at obtaining the
same results. e ultimate judgment concerning the propriety of any course of conduct must be
made by the clinician aer consideration of each individual patient situation. Neither IGC,
the medical associations, nor the authors endorse any product or service associated with the
distributor of this clinical reference tool.
Source
American Academy of Ophthalmolog y Retina/Vitreous Panel. Preferred Practice
Pattern
®
Guidelines. Diabetic Retinopathy. San Francisco, CA: American Academy of
Ophthalmolog y; 2014. Available at: www.aao.org/ppp.
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AAODRET15043b
Table 9. Side Effects and Complications of Treatment for
Diabetic Retinopathy
Treatment Side Effect/Complication
Focal laser
photocoagulation
for diabetic
macular edema
• Possible transient initial decrease in central vision
• Paracentral scotomas if laser burns have been placed close to the
fovea, especially large or confluent burns
• Permanent central scotoma from inadvertent foveal burns
• Expansion of laser scar area (over many years)
Panretinal
photocoagulation
(scatter) for
severe NPDR or
PDR
• Transient central vision loss from macular edema
• Peripheral visual field constriction with delayed dark adaptation
• Vitreous hemorrhage if neovascularization is present
• Reduced or compromised accommodation
• Pupillary dilation (mydriasis)
Vitrectomy • Recurrent vitreous hemorrhage
• Retinal tear or detachment
• Vision loss
• Infectious endophthalmitis
• Cataract
Intravitreal
injections
• Cataract
• Elevated IOP (i.e., corticosteroids)
• Infectious endophthalmitis
• Noninfectious inflammatory reactions
• Possible systemic effect from intravitreal medication
• Increased retinal traction
IOP, intraoclar pressure; NPDR, nonproliferative diabetic retinopathy; PDR,
proliferative diabetic retinopathy
