| Laser photocoagulation compared to no treatment (or deferred treatment) for diabetic retinopathy |
| Patient or population: people with diabetic retinopathy
Settings: Ophthalmology clinics
Intervention: laser photocoagulation
Comparison: no treatment or deferred treatment |
| Loss of 15 or more letters BCVA Follow‐up: 12 months | Low risk (non‐proliferative DR) | RR 0.99
(0.89 to 1.11) | 8926
(2 RCTs) | ⊕⊕⊝⊝
LOW 1,2 | The pooled RR 0.99 (0.89 to 1.11) is derived from one study with mainly low risk population RR 1.07 (0.92 to 1.23) and one study with mainly high risk population 0.86 (0.71 to 1.04) |
| 100 per 1000 | 99 per 1000
(89 to 111) |
| High risk (proliferative DR) |
| 250 per 1000 | 248 per 1000
(223 to 278) |
| BCVA measured using logMAR acuity (0 = 6/6 visual acuity, higher score is worse visual acuity) Follow‐up: 12 months | The mean BCVA at 12 months in the control group was 0.12 logMAR | The mean BCVA at 12 months in the intervention group was 0.02 logMAR units higher (worse; 0.23 lower to 0.27 higher) | | 36
(1 RCT) | ⊕⊕⊝⊝
LOW 1,3 | |
| Severe visual loss (BCVA < 6/60) Follow‐up: 12 months | Low risk (non‐proliferative DR) | RR 0.46
(0.24 to 0.86) | 9276
(4 RCTs) | ⊕⊕⊕⊝
MODERATE 1,4 | |
| 10 per 1000 | 5 per 1000
(2 to 9) |
| High risk (proliferative DR) |
| 50 per 1000 | 23 per 1000
(12 to 43) |
| Progression of diabetic retinopathy Follow‐up: 12 months | Low risk (non‐proliferative DR) | RR 0.49
(0.37 to 0.64) | 8331
(4 RCTs) | ⊕⊕⊝⊝
LOW 1,5 | |
| 100 per 1000 | 49 per 1000
(37 to 64) |
| High risk (proliferative DR) |
| 400 per 1000 | 196 per 1000 (148 to 256) |
| Quality of life Follow‐up: 12 months | See comment | See comment | | | | No studies reported this outcome |
| Pain Follow‐up: at time of treatment | See comment | See comment | | | | No studies reported this outcome |
| Loss of driving licence Follow‐up: within three months of treatment | See comment | See comment | | | | No studies reported this outcome |
| *The basis for the assumed risk (e.g. the median control group risk across studies) is provided in footnotes. The corresponding risk (and its 95% confidence interval) is based on the assumed risk in the comparison group and the relative effect of the intervention (and its 95% CI).
CI: Confidence interval; DR: diabetic retinopathy; BCVA: Best corrected visual acuity |
| GRADE Working Group grades of evidence
High quality: further research is very unlikely to change our confidence in the estimate of effect.
Moderate quality: further research is likely to have an important impact on our confidence in the estimate of effect and may change the estimate.
Low quality: further research is very likely to have an important impact on our confidence in the estimate of effect and is likely to change the estimate.
Very low quality: we are very uncertain about the estimate. |
