Our Experience with the Treatment of Diabetic Maculopathy

Overview

The authors evaluate group of 111 eyes with diabetic macular edema treated bylaser photocoagulation. The criterion to start laser therapy was biomicroscopicallyevident clinical significant macular edema. The visual acuity (VA) is evaluatedduring 1 – 5 years after thephotocoagulationwasstarted.ThegroupwithstabilizedVA includes eyes with change of VA up to one line of Snellen optotypes. The groupswith improved or worsened VA include eyes with change of 2 or more lines ofSnellen optotypes. In the first year after the beginning of photocoagulation, VA in87 eyes (78 %) was stabilized, in 20 eyes (18 %) improved, and in 4 eyes (4 %)worsened. In the second year after the beginning of photocoagulation, VA in 85eyes (77 %) was stabilized, in 19 eyes (17 %) improved, and in 7 eyes (6%)worsened.In the fifth year, VA in 82 eyes (74 %) was stabilized, in 12 eyes (11 %) improved,and in 17 eyes (15 %) worsened comparing to the findings of first examination. Itis evident from the study, the group with stable VA during the 5 years periodchanges a little bit, in the group with improved VA it is a perceptible decline from18 % to 11 %. The most evident change is seen in the group with worsened VA – here we can notice an interesting conspicuous tendency of doubling the numberof worsened eyes during each two years. Whereas 1 year after the beginning of thephotocoagulation it consists of 4 eyes (4 %) only, two years later, this is in the thirdyear, it is 9 eyes (8 %), and another two years later, thus 5 years after the beginningof photocoagulation it is already 17 eyes (15 %). Very important finding is the lownumber of eyes in the group with worsenedVA– together 7 (6%) at the examinationperformed 2 years after of the photocoagulation has been started because it isconfirmed that in groups without treatment the number of eyes with worsenedVA exceeds 50 %. The photocoagulation near the center of the macula has to beperformed with considerable caution – the authors have the experience thatduring several years after the photocoagulation the atrophic lesion enlarges upto twice its size to the original one, especially in older patients.

Key words:
diabetic maculopathy, macular edema, argon laser and visual acuity