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How effective is laser photocoagulation for proliferative diabetic retinopathy?
Compared with no treatment or deferred treatment, laser photocoagulation is beneficial for treating proliferative diabetic retinopathy (PDR). Treatment with laser photocoagulation reduced the risk of severe visual loss by over 50% at 12 months, with a similar effect on the progression of PDR and the risk of vitreous haemorrhage.
There were only 5 studies. The quality of the evidence was judged to be moderate or low, reflecting the fact that 4 of the studies were conducted some time ago (1977, 1978, 1980 and 1991), when standards of trial conduct and reporting were lower; heterogeneity was also present. None of the studies reported patient-relevant outcomes, such as quality of life, pain or loss of driving licence, or adverse effects such as retinal detachment.
Laser photocoagulation is an intervention in which light energy is applied to the retina with the aim of stopping the growth and development of new blood vessels, and thereby preserving vision. It is commonly used to treat PDR.
Evans JR et al. Laser photocoagulation for proliferative diabetic retinopathy. Cochrane Reviews, 2014, Issue 11. Art. No.: CD011234.DOI: 10.1002/14651858. CD011234.pub2. This review contains 5 studies involving 4786 participants (9503 eyes).
Cochrane Systematic Reviews for primary care practitioners
Developed by the Cochrane Primary Care Field, New Zealand Branch of the Australasian Cochrane Centre at the Department of General Practice and Primary Health Care, University of Auckland and funded by the Ministry of Health and New Zealand Doctor. PEARLS are meant for educational use and not to guide clinical care. New Zealanders can access the Cochrane Library free via www.cochrane.org.nz
Otolaryngologist, head and neck surgeon Francis T. Hall discusses the evaluation of thyroid nodules, which primarily aims to determine the likelihood of malignancy. He then reviews the treatment of thyroid nodules and thyroid cancer, including recent advances in management
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