Proliferative Diabetic Retinopathy Clinical Trial
Official title:
A Prospective Clinical Study of the Effects of Panretinal Photocoagulation Delivered With a Multi-spot Photocoagulator on Retinal Sensitivity and Driving Eligibility in Patients With Diabetic Retinopathy
The purpose of this study is to determine the risk of failing the visual field criteria to hold a driving license following retinal laser treatment delivered with a multi-spot photocoagulator.
Despite improvements in the management of diabetes, the incidence of severe diabetes
-related eye disease remains high. Laser treatment (panretinal photocoagulation (PRP)) is
the gold standard treatment for reducing the risk of visual loss. However, evidence suggests
that PRP can be damaging on visual field function and thus jeopardize patients' eligibility
to drive. In the UK, it is the patient's responsibility to inform the DVLA that they are
receiving retinal laser.
With the use of a multi-spot Photocoagulator for application of PRP at Moorfields the
investigators are in a unique position to assess the effects of laser applied with this new
delivery system on visual fields in a detailed fashion. Thus providing more accurate advice
on visual prognosis and visual field function and addressing the risk of losing the ability
to drive.
All treatment-naive patients with severe diabetic retinopathy requiring bilateral retinal
laser treatment will be identified. Following informed consent these patients will undergo
baseline visual field testing which will be of a duration of approximately 30 minutes and
complete a quality of life questionnaire. All patients will receive their laser treatment as
part of standard clinical care via the multi-spot Photocoagulator which will require
approximately four 20 minute sessions. At 6 months following the completion of treatment the
patients will undergo repeat visual field testing as conducted at baseline and complete a
quality of life questionnaire. The investigators hope to recruit 100 patients.
Analysis of visual fields will principally involve assessment of whether patients have met
the UK driving standards on Estermann VF testing. A quantitative assessment of change in
retinal sensitivity will be undertaken by comparing retinal sensitivity pre and post-PRP.
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Intervention Model: Single Group Assignment, Masking: Open Label, Primary Purpose: Health Services Research
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