Fluorescein angiographically evident diabetic maculopathy

Diabetic maculopathy seen in the Philippines, specifically, the associated factors, the various lesions seen on fluorescein angiography, and the visual acuity associated with these lesions were characterized using 127 patients (254 eyes) with diabetic retinopathy based on the fluorescein angiography done at the Eye Referral Center in 1993. Results showed that 116 (91.34%) patients have maculopathy, the majority of which is bilateral (84.25%). Age (p=0.675), sex (p=0.357), hypertension (p=0.742), duration of diabetes (p=0.778) and myopia (p=0.742) were not significantly associated with maculopathy. However, severity of retinopathy (p=0.001) was significantly associated with it. Fluorescein angiographic findings are macular staining (83.86%), perifoveal capillary dropout or macular ischemia (10.76%), and preretinal traction and membrane (5.38%). Microaneurysm (72.65%) is the most common lesion associated with macular staining, followed by capillary leakage (4.04%), cystoid macular edema (3.59%), perifoveal capillary dropout with microaneurysm (2.24%), and capillary with microaneurysm leakage (1.34%). Exudates are associated with microaneurysm, perifoveal capillary dropout or a combination of the two. Vision was found to be marginally statistically different between the normal and maculopathy group (p=0.0505). The worst vision was seen in macular ischemia and preretinal traction and membrane, with mean visual acuity of 0.18 and 0.25, respectively. It is concluded that severity of retinopathy is the only variable significantly associated with maculopathy in this study. Good vision does not necessarily indicate a normal macula. Detailed examination and fluorescein angiography should be carried out, regardless of duration of diabetes.