This 51YO male has heavy bilateral panretinal photocoagulation (PRP) scarring for proliferative diabetic retinopathy (PDR). All laser treatments were done years earlier at an outside practice.
The burns are confluent and extend into the arcades. Thankfully, the treating surgeon did not quite burn the optic nerves. However, the visual fields are severely constricted with essentially iatrogenic retinitis pigmentosa.
Learning Points:
Although possibly appropriate before the advent of modern vitrectomy surgery and anti-VEGF therapy, this degree of laser should never be seen in today’s patients.
Laser should begin well outside the arcades and away from the optic nerve, extending as anteriorly as possible, using 200- to 500-micron retinal burns spaced about one burn width apart.
