Visual outcome of laser treatment in diabetic macular edema: Study from an Urban Diabetes Care Center

Abstract

Objective:To determine the visual outcome of laser treatment in clinically significant macular edema.Methods:This interventional and qausi experimental study was carried out at Diabetic Association of Pakistan (DAP) during January 2011 and December 2012. Approval was taken from Research Ethical Committee of Isra Postgraduate Institute of Ophthalmology. Records of 925 eyes of 464 patients with “Clinical Significant macular edema” (CSME), treated with laser photocoagulation were analyzed. Best-corrected visual acuity (BCVA) at the time of presentation and at the last follow up, minimum of one year and maximum of 45 months was recorded and compared. SPSS version 20.0 was used to analyze the data.Results:Diabetic retinopathy was found in 20.3% (1777) of 8742 diabetic attending DAP Hospital” amongst whom 39.6% (705) had Sight threatening diabetic retinopathy. Laser was advised in 96.4% (680) individuals, accepted by 70.5% (480) individuals. Amongst 960 eyes of 480 patients who accepted laser, 925 eyes had clinically significant macular edema and 35 eyes had PDR who are not included in this study. Amongst 925 eyes with CSME, Grid laser was done in 913 eyes (99%) and focal laser was done in 12 eyes (1%). After a follow up of 12 to 45 months, it was found that best corrected visual acuity had declined in 2.4% (22) eyes, stabilized in 67% (619) eyes and improved in 30.7% (284) eyes. One line improvement on Snellen’s chart was fond in 21.3% (197) eyes, 2 lines in 8% (74) eyes, 3 lines in 1.2% (12) eyes and 4 lines in one (0.1%) eye with p-value of 0.000.Conclusion:Laser therapy is an effective treatment in stabilizing/improving the vision in diabetic macular edema particularly at those centers where only Argon Laser is available and OCF, FFA facilities do not exist.

Frequency and risk factors of diabetic retinopathy in patients with type 2 diabetes presenting at a tertiary care hospital

“…On the other hand, studies on population with DR had CSME 36% which is higher than others (19.2%, 6.27%, 15.1%, and 5.78%) previously reported by Shrestha, et al, Raman et al, Benarous et al, and Thapa et al, respectively [25][26][27][28]. Similarly, the sight-threatening CSME with severe NPDR was 47.8% [29]. CSME with moderate and severe NPDR and PDR reported a significant correlation [19].…”

“…Similarly, the sight-threatening CSME with severe NPDR was 47.8% [29]. CSME with moderate and severe NPDR and PDR reported a significant correlation [19]. According to gender, NPDR (with CSME and without CSME) was associated with male, whereas PDR was associated with female (without CSME), and CSME in male was more prevalent.…”

“…The poor glycemic control was significantly associated with severity of retinopathy [18]. In previous studies, logistic regression analysis showed that males are 3.5 times more prone to develop DR due to some confounding factors such as obesity or hypertension [19] Duration of diabetes is also a risk indicator for developing retinopathy [17].…”