Visusergebnisse bei diabetischer Makulopathie nach zentraler Photokoagulation

Abstract

Diabetic macular edema is shown to be treated successfully by central focal argon laser coagulation in most cases. Since February 1986, diabetic patients with macular edema were evaluated prospectively and treated by focal argon laser coagulation and/or grid pattern. A second group of diabetic patients with comparable macular edema and similar retinal changes was explored retrospectively. Visual acuity after treatment in relation to preoperative visual acuity was measured and statistically compared with visual acuity of the second group without laser treatment. The results show that laser treatment is important for stabilization of visual acuity but does not increase visual acuity beneath 0.2. Indications for treatment are discussed.

Influence of Serum Lipid Fractions on the Course of Diabetic Macular Edema after Photocoagulation

“…Oik [4] even demonstrated a significant improvement of visual acuity in patients with diffuse diabetic macular edema after modified grid photo coagulation. Our own studies and clinical observation have confirmed these findings [5,6], However, it has been shown that patients with similar degrees of diabetic macular edema undergoing grid photocoagulation following the recom mendations of the ETDRS [2,3] present differing visual outcome values upon being treated by laser. Systolic blood pressure [7] and blood glucose [8,9] have been reported ear lier to be important influences on the progress of diabetic retinopathy.…”

Cost-Benefit Analysis of Diabetic Eye Disease

“…As already mentioned, under these conditions 73% of all patients who go blind due to proliferative retinopathy [23] and 67% of those due to diabetic macular edema [20] can be saved from blindness, or blindness can be somewhat de layed in unpreventable cases.…”

“…b Annual number of persons who will develop PDR/CSME, calcu lated from incidence rates. Depending on the patient's vision at the time he developed diabetic retinopathy, clinically significant macular edema causes blindness in oncthird of affected diabetics within 3 years (mean 1.5 years), in anoth er third within 6 years (mean 4.5 years) and in the final third within 9 years (mean 7.5 years) [6,20]. Thus, after a mean o f 7.5 years all 168 patients with proliferative retinopathy and all 84 with significant mac ular edema will be blind (table 2).…”

“…Assuming 100% diagnosability and 100% treatability, the risk of blindness can be reduced by 73% for proliferative retinopathy [23] and by 67% for significant macular edema [20] and vision of at least one eye can be preserved.…”

“…In one third of the patients a loss of vision to <10/100 is unpreventable. Due to their poorer vision at onset of the disease, these diabetics would go blind in a mean of 1.5 years, which could be delayed by some 4 years with laser coagulation [20], …”