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June 1969

Photocoagulation and Local Steroid-Induced Ocular Hypertension in the Treatment of Diabetic Retinopathy

Author Affiliations

Clearwater, Fla; Durham, NC

From the Department of Ophthalmol-; ogy, Duke University Medical Center, Durham, NC.

Arch Intern Med. 1969;123(6):626-631. doi:10.1001/archinte.1969.00300160016003

Photocoagulation and dexamethasone have been used in the treatment of 50 eyes with diabetic retinopathy. The progression of the retinopathy appears to be slowed by both photocoagulation and steroid-induced glaucoma. Photocoagulation appears to be particularly applicable in the therapy of early diabetic retinopathies in which the major abnormalities are located in the midperiphery and posterior pole of the fundus. Dexamethasone-induced ocular hypertension appeared to be useful in the therapy of all stages of diabetic retinopathy. Photocoagulation improved the vision in 22% of the eyes. Steroid-induced ocular hypertension was associated with the improvement in vision in 38% of the eyes. Combined therapy resulted in improvement in vision in 44% of the eyes. Both photocoagulation and ocular hypertension reduce the incidence of hemorrhages. Proliferative neovascularization regressed with a steroid-induced ocular hypertension of greater than 40 mm Hg in three eyes. The combined therapy is well tolerated, easily carried out, and associated with