Nadeem Ishaque, Nafis ur Rahman.
Prevention of significant Visual Loss in Diabetic Macular edema by early Laser Photocoagulation.
Pak J Ophthalmol Jan ;14(2):73-6.

Diabetic macular edema is an established cause of visual loss in both the insulin-dependent early onset and the noninsulin-dependent maturity onset diabetes mellitus. A one-year prospective study was conducted at the diabetic clinic of Al-Shifa Eye Hospital, Rawalpindi, to study the incidence of diabetic macular edema in patients with mild to severe preproliferative diabetic retinopathy and to study the effects of laser treatment in the management of such cases in view of the various diabetic retinopathy treatment trials. A total of 123 patients out of 537 examined in the clinic having clinically significant macular edema were included in the study. The ages of the patients Included In the study ranged from 37 to 70 years with a duration of diabetes varying from 3 to 18 years. All patients included in the study had bilateral involvement making a total of 246 eyes. The Incidence of macular edema In this study was 22.9%. Out of the 246 eyes subjected to laser treatment, either focal or grid, 16 (6.50%) showed improvement of a maximum of 2 lines from the baseline visual acuity. In 66 eyes (26.82%) there was no change in pre-laser visual acuity. There was a drop of one line in 88 eyes (35.8%), while 41 (16.7%) had a drop of two lines from the baseline level. 33 eyes (13.4%) had a drop of three lines or more. Thirty-seven patients (30.08%), i.e., 74 eyes had a progression of retinopathy and required panretinal photocoagulation. This study shows a relatively high Incidence of macular edema In preproliferative cases and confirms that early laser treatment should be considered for treatment of diabetic edema involving the macula or threatening the macula.

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