The effect of patient characteristics on response to focal laser treatment for diabetic macular edema.
OBJECTIVE
The purpose of the study was to determine which patient characteristics influence response to focal photocoagulation for clinically significant diabetic macular edema (CSME).


METHODS
A retrospective chart review was performed of 547 eyes from 361 patients who were observed for at least 1 year (mean, 2.6 +/- standard deviation 1.7 years) after surgery. Preoperative patient characteristics were tested for their significance in predicting outcome using multiple regression analysis.


RESULTS
Increasing patient age has a negative effect on visual outcome (P = 0.0179). Patients with diet-controlled diabetes show improvement in mean vision, whereas patients whose diabetes is controlled with insulin, oral agents, or both show declines, and these differences are significant (P < 0.0001). Neither cataract surgery before or after focal photocoagulation nor simultaneous panretinal photocoagulation for patients having concomitant high-risk proliferative retinopathy had a significant effect on outcome.


CONCLUSIONS
Younger patients with CSME and those with diet-controlled diabetes can be given more favorable prognoses. Patients with CSME and high-risk proliferative disease can have cost-effective simultaneous focal and panretinal photocoagulation without adversely affecting visual outcome.
Browning
D J
DJ
Charlotte Eye Ear, Nose, and Throat Associates, NC 28204, USA.
Zhang
Z
Z
Benfield
J M
JM
Scott
A Q
AQ
D000328:Adult; D000368:Aged; D003710:Demography; D048909:Diabetes Complications; D003920:Diabetes Mellitus / Q000503:physiopathology / Q000628:therapy; D003930:Diabetic Retinopathy / Q000150:complications / Q000503:physiopathology / Q000601:surgery*; D004487:Edema / Q000150:complications / Q000503:physiopathology / Q000601:surgery*; D005260:Female; D006801:Humans; D017075:Laser Coagulation; D008266:Macula Lutea / Q000503:physiopathology / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D012044:Regression Analysis; D012164:Retinal Diseases / Q000150:complications / Q000503:physiopathology / Q000601:surgery*; D012189:Retrospective Studies; D016896:Treatment Outcome; D014792:Visual Acuity