[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.
Ohkoshi
Kishiko
K
Department of Ophthalmology, St. Luke's International Hospital, Tokyo, Japan.
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003930:Diabetic Retinopathy / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008028:Light Coagulation; D008269:Macular Edema / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D012189:Retrospective Studies; D012307:Risk Factors; D014792:Visual Acuity