[Visual prognosis and prognostic risk factors after photocoagulation for diffuse diabetic macular edema].

OBJECTIVE

To investigate the efficacy of photocoagulation for diffuse diabetic macular edema.

METHODS

One hundred and fifty eyes with diffuse diabetic macular edema were treated by laser photocoagulation (grid pattern photocoagulation, in some instances combined with direct photocoagulation) and followed up more than 1 year. The visual prognosis of these cases was retrospectively studied.

RESULTS

The logarithm of the minimum angle of resolution (Log MAR) final visual acuity after photocoagulation was improved more than 0.2 levels in 62 eyes (41%) of a total 150 eyes, and in 60% of 87 eyes in which preoperative visual acuity had been less than 0.5. Average visual acuity after photocoagulation reached a plateau within three months after surgery, and 84% of the eyes with 0.5 or better preoperative visual acuity achieved 0.5 or better final visual acuity. There was correlation between visual prognosis and the following preoperative factors: preoperative visual acuity, hard exudates, fluorescein leakage, grid area, hyperlipidemia, and renal failure.

CONCLUSIONS

Grid photocoagulation as a treatment for diffuse diabetic macular edema is effective to improve or maintain visual acuity. Alternative treatment such as vitrectomy should be considered after three-month observation on the outcome of grid photocoagulation.