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S. B. Jyothi, A. Yandra, F. Mubashar, T. Adewoyin, S. Sivaprasad; Long-Term Visual Outcome Following Laser Photocoagulation for Diabetic Macular Oedema in Afro Caribbeans. Invest. Ophthalmol. Vis. Sci. 2009;50(13):4415.
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© ARVO (1962-2015); The Authors (2016-present)
To evaluate the efficacy of focal/grid photocoagulation for the treatment of diabetic macular edema (DME) in Afro-Caribbeans.
The visual outcome of one hundred Afro-Caribbean subjects with DME involving the fovea that had photocoagulation at least 5 years ago was retrospectively analyzed. In bilateral cases, the eye with the worse visual acuity was included. Systemic and local factors that influenced outcome were also assessed.
The mean gain in visual acuity at the end of 5 years is 4.05±17 ETDRS letters. There was no statistical difference between Africans and Caribbeans (P = 0.15). Eleven percent lost more than 15 letters and 23% gained more than 15 letters. The mean time lag between onset of Diabetes and first laser treatment is 12 years. At presentation 73% had mild non proliferative diabetic retinopathy, 11% had moderate to severe and 11% had proliferative retinopathy. The mean number of laser sessions in the five years was 2.69 macular lasers. Four percent had previous pan retinal photocoagulation (PRP) and 34% had PRP in the 5 year follow up with an average time lag between focal and PRP of 30 months. Four percent had vitreo-retinal procedures, 16% had cataract surgery and 4% had intra vitreal triamcinolone for non-resolving macular thickness during the follow up. Twenty three subjects were concomitantly being treated for glaucoma. The systemic associations included hypertension in 73% of subjects, with 31% being on 3 or more drugs, 23% had macro-vascular complications. Nearly 50% were on both Insulin and oral anti diabetic drugs as standard treatment. Mean time to laser from the initiation of insulin to the regime was 10±27 months. Having macular laser in the other eye did not influence the visual outcome (P = 0.4). Each patient attended an average of 17 retina clinic appointments, and at 5 yr follow up 4 patients were deceased.
The 5 year visual outcome following macular photocoagulation for DME in Afro-Caribbeans does not differ significantly from the published literature on predominantly Caucasian cohorts.
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