Recurrent Proliferative Diabetic Retinopathy with Vitreous Hemorrhage After Panretinal Photocoagulation

This 39 year old woman with type 1 diabetes mellitus for 25 years had previously had panretinal photocoagulation for retinal neovascularization. She noted new floaters and was found to have a fresh preretinal hemorrhage with a patch of neovascularization elsewhere inferotemporally (white arrow). Her visual acuity was 20/25 in the right eye. She has room for additional laser photocoagulation. Therefore, supplemental panretinal laser photocoagulation would be a reasonable treatment. Also reasonable would be observation, with vitrectomy if repeated hemorrhages interfere with her quality of life. In favor of the latter approach would be the presence of a nearly complete pattern of laser already, and a desire not to further compromise peripheral visual field and night vision.