[Diabetic maculopathy]

Diabetic maculopathy is a leading cause of decreased vision from diabetic retinopathy. It is usually encountered in older non-insulin-dependent diabetics with mainly nonproliferative diabetic retinopathy. Diabetic maculopathy can be divided into three main types, exudative (focal), edematous (diffuse or cystoid) and ischemic. Many reports do not distinguish among the various forms of diabetic maculopathy, but only discuss the diabetic macular edema which is the first and the most dominant sign of diabetic maculopathy. No drug therapy has shown to have therapeutic effect in diabetic maculopathy. Photocoagulation, although, symptomatic, is of benefit in edematous and exudative diabetic maculopathy, in the sense that it produces an improvement or maintenance of the clinical picture and visual acuity. Thereby, good glycemic control and the treatment of potential systemic diseases such as hypertension and renal failure are recommended. Photocoagulation is focal, applied directly at microaneurysms and areas of fluorescein leakages and in a "grid" pattern for diffuse macular edema. Fluorescein angiography is necessary to discover the areas of fluorescein leakage, and is helpful in the follow-up of treatment results.