A 30-year-old woman with type 1 diabetes for 18 years presents with vitreous hemorrhage. Fundus fluorescein angiography shows new vessels at the disc (NVD) with fibrovascular proliferation. Which laser treatment modality is indicated for this stage?

• A Focal laser photocoagulation of microaneurysms only
• B Sub-threshold micropulse laser to the macula
• C Photodynamic therapy with verteporfin
• D Panretinal photocoagulation (PRP) to ablate peripheral ischemic retina ✓

Explanation

Proliferative diabetic retinopathy (PDR) with NVD or NVE (new vessels at disc or elsewhere) is an indication for panretinal photocoagulation (PRP), which destroys the peripheral ischemic retina that drives VEGF production. By reducing the angiogenic stimulus, PRP causes regression of neovascularisation and reduces the risk of vitreous hemorrhage and tractional retinal detachment. Focal laser is used for clinically significant macular edema, not for proliferative disease.

Reference: Khurana Comprehensive Ophthalmology, 7th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.