Panretinal laser therapy, an effective treatment for sight-threatening diabetic retinopathy, should prompt a major review of diabetes management because retinopathy suggests that other microvascular disease is present, and probably macrovascular disease as well.
Panretinal laser therapy is an important part of the management of diabetic retinopathy but the need for the procedure may be a game changer for diabetes management and the procedure itself is often a life-changer for the patient. Both the diabetes health professional team and the patient are confronted with the reality of visual loss, the potential of future visual loss and blindness, and the virtual certainty of severe microvascular disease in other systems of the body (neuropathy and nephropathy) as well as the likelihood of macrovascular disease (atherosclerotic cardiovascular disease).
This article discusses the implications of requiring and having panretinal laser therapy for proliferative diabetic retinopathy. It is the first in a series of articles reviewing clinical situations that indicate a major change in the level of risk of diabetes-related complications and prompt the need for a major review of diabetes management. Some background information on retinopathy and panretinal photocoagulation is given.