[Personal experience in treatment of diabetic maculopathy].
The authors evaluate group of 111 eyes with diabetic macular edema treated by laser photocoagulation. The criterion to start laser therapy was biomicroscopically evident clinical significant macular edema. The visual acuity (VA) is evaluated during 1-5 years after the photocoagulation was started. The group with stabilized VA includes eyes with change of VA up to one line of Snellen optotypes. The groups with improved or worsened VA include eyes with change of 2 or more lines of Snellen optotypes. In the first year after the beginning of photocoagulation, VA in 87 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 85 eyes (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. It is evident from the study, the group with stable VA during the 5 years period changes a little bit, in the group with improved VA it is a perceptible decline from 18% 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 number of worsened eyes during each two years. Whereas 1 year after the beginning of the photocoagulation it consists of 4 eyes (4%) only, two years later, this is in the third year, it is 9 eyes (8%), and another two years later, thus 5 years after the beginning of photocoagulation it is already 17 eyes (15%). Very important finding is the low number of eyes in the group with worsened VA--together 7 (6%) at the examination performed 2 years after of the photocoagulation has been started because it is confirmed that in groups without treatment the number of eyes with worsened VA exceeds 50%. The photocoagulation near the center of the macula has to be performed with considerable caution--the authors have the experience that during several years after the photocoagulation the atrophic lesion enlarges up to twice its size to the original one, especially in older patients.
Rehák
J
J
Ocní klinika FN a LF UP, Olomouc. rehakj@fnol.cz
Chrapek
O
O
Pracharová
Z
Z
Gbelcová
M
M
D003930:Diabetic Retinopathy / Q000503:physiopathology / Q000601:surgery*; D005500:Follow-Up Studies; D006801:Humans; D017075:Laser Coagulation; D008269:Macular Edema / Q000503:physiopathology / Q000601:surgery*; D014792:Visual Acuity