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Does conventional laser photocoagulation still have a place in the treatment of diabetic macular edema?
Belma Kayhan1, Engin Burumcek2
1Department of Ophthalmology, University of Health Sciences, Sultan 2. Abdulhamid Han Training and Research Hospital, Istanbul, Turkey.
Abstract:
Objective: The study aimed to investigate the long-term efficacy of conventional laser photocoagulation in the treatment of diabetic macular edema. Methods: In this retrospective study, the records of patients presented with diabetic macular edema (DME) and non-proliferative diabetic retinopathy were reviewed. DME defined as clinically significant macular edema was treated by using argon green or yellow dye laser with focal, grid, and modified grid techniques according to Early Treatment Diabetic Retinopathy Study parameters. Best-corrected visual acuity (BCVA) was measured. BCVA change after the treatment and its relationship with other factors were evaluated. Results: The study included 133 eyes of 81 patients. The mean follow-up was 28.26 months. BCVA demonstrated the increase of 2 lines or more in 20.7% of the eyes, stabilization within 2 lines in 60.7% of the eyes, and loss of 2 lines or more in 18.3% of the eyes. The eyes with baseline BCVA lower than or equal to 0.50 showed a statistically significant increase (p=0.001) whereas the eyes with baseline BCVA of more than 0.50 did not show a statistically significant change (p=0.070) after laser photocoagulation treatment. Conclusions: Conventional laser photocoagulation is an effective treatment in diabetic macular edema including center-involved type and stabilizes visual acuity in the majority of the patients. Improvement in BCVA is significant in the group with lower baseline BCVA. Abbreviations: DM = diabetes mellitus, DME = diabetic macular edema, ETDRS = early treatment diabetic retinopathy study, CSME = clinically significant macular edema, CLP = conventional laser photocoagulation, VEGF = vascular endothelial growth factor, BCVA = best-corrected visual acuity, ANOVA = analysis of variance, VA = visual acuity.
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