English abstract
Objectives: Diabetic macular edema results in irreversible loss of
vision and is the major cause of visual morbidity in patients with
Diabetes of adult onset. DCCT trial has linked this to poorer
control and increased duration of DM. laser treatment in such
cases is known to reduce visual impairment by 50% for a period
of 5 years. The aim of this study is to evaluate the effect of laser
on visual outcome in patients with clinically significant macular
edema and also evaluate the effect of some factors like control of
blood sugar, hypertension, nephropathy etc.
Methods: Retrospective analysis of 165 eyes of patients with
diabetic maculopathy who underwent laser as per the ETDRS
(early treatment diabetic retinopathy study) protocol was made.
All these patients underwent Visual Acuity check, slit lamp
examination of anterior segment, IOP check and after dilatation
detailed examination of macula with 78/90 d lens and areas of
retinal thickening recorded and subjected to focal laser/grid
laser depending upon whether the maculopathy was focal/
diffuse. Patients were assessed for control of sugar and presence
of hypertension/nephropathy or any other related systemic
diseases. Patients were followed up for a minimum of 6 months
to a maximum of 24 months. The visual acuity at the end of 3-4
months was taken as final visual acuity after laser.
Results: 165 eyes of patients having CSME (clinically significant
macular edema) were subjected to laser. 108 (64.54%) eyes
underwent focal laser and the rest were given grid laser. 153
eyes underwent macular laser without PRP (Pan retinal
photocoagulation) while rest had even PRP along with macular
laser. 92 eyes (55.75%) totally, 39 eyes (59.1%) in controlled group
and 26 eyes (56.5%) in the controlled group and 12 eyes (54.5%)
in patients with hypertension had stable vision 3-4 months after
laser. 44 eyes (26.7%) overall, 18 eyes (27.3%) in controlled group,
16 eyes (34.8%) in uncontrolled group and 7 eyes (31.8%) in
hypertensive showed improvement of vision after laser.
Conclusion: More than 50% of eyes of patients who underwent
laser had stabilization of VA and >25% of eyes had improvement
in VA. No correlation was found between outcome of laser and
control of blood sugar and associated hypertension.
