Purchase this article with an account.
A. Chabi, C. Rosende, J.C. Macdonald, W.A. J. van Heuven; Visual Acuity after Focal Laser Photocoagulation in Clinically Significant Macular Edema . Invest. Ophthalmol. Vis. Sci. 2004;45(13):4087.
Download citation file:
© ARVO (1962-2015); The Authors (2016-present)
Purpose: The purpose of this study was to determine the efficacy of Focal Laser Photocoagulation (LPC) for all stages of clinically significant macular edema (CSME) in reducing the risk of visual loss. Data from the Early Treatment Diabetic Retinopathy Study (ETDRS) proved the benefits of focal LPC of CSME in reducing the risk of visual loss. The ETDRS focused on focal LPC use in only those patients with mild and moderate CSME, although it also suggested that the same benefits would probably be found for treatment of more advanced CSME. This study focused on patients at a resident clinic at an academic center. The patients included those with mild, moderate, and severe NPDR with CSME as well as those with PDR. Methods: A retrospective chart review was performed on 53 diabetic patients who received focal LPC from January of 2001 to January of 2002 at the Texas Diabetes Institute Ophthalmology Clinic. Patients who were receiving PRP on the same visit were excluded. The patients’ records were then reviewed to note VA before and after focal LPC. The post–treatment visual acuities recorded were from the 1 month to 4 months post–treatment and/or the +4 to 12 months post–treatment periods. Patients without follow–up in the 12 months post–treatment were excluded. Any retreatment with focal LPC’s within the 12 months after initial treatment was also noted. Results: Among the 53 patients, the average age was 55.6 years old. The pretreatment VA ranged from 20/20 to CF at 6 feet. The mode and mean were 20/25 and 20/50 respectively. Approximately 24.5% of patients showed improved VA, 24.5% showed no change, and approximately 50.9% showed a decrease in visual acuity in the 12 months post–treatment. Approximately 26.4% of patients received retreatment with focal LPC within that year. Conclusions: The ETDRS found that the incidence of moderate visual loss in all eyes with diabetic macular edema was 5% at one year for patients treated with focal LPC. This figure did not include those who experienced mild or severe visual loss. Our finding of 50.9% included any level of loss. The ETDRS also found that visual prognosis was worse for those with lower pre–treatment VA’s. Our patients had a mean starting VA of 20/50; whereas, ETDRS had enrolled only those with VA’s of 20/40 or better. Our population included not only the mild and moderate NPDR with CSME patients that ETDRS enrolled but also severe NPDR with CSME and PDR patients. We suspect that visual losses in our patients with severe NPDR with CSME and PDR may be more due to progression of their diabetic retinopathy rather than lack of effectiveness of focal LPC on their CSME. Further studies need to be done.
This PDF is available to Subscribers Only