Xenon arc photocoagulation for the treatment of diabetic maculopathy. Interim report of a multicentre controlled clinical study.

Abstract

SUMMARY The results of a randomised controlled clinical study in the treatment of diabetic maculopathy are reported. Ninety-nine patients with two similarly affected eyes had one-chosen by random procedure-treated, while the other was left as an untreated control. Visual acuity was maintained in the treated eyes, while it deteriorated in the untreated eyes, reaching over 2 lines difference after 4 years. The difference in deterioration was significantly less in treated than in untreated eyes at each assessment. After 4 years the difference between the 2 eyes was greatest in those with initially good vision. There was no difference in visual acuity in patients whose initial vision was less than 6/36. Only 9 treated but 25 control eyes lost vision to blindness (P < 0f00 1). It is concluded that maculopathy is a treatable form of diabetic retinopathy if treated before severe visual loss occurs.In diabetic retinopathy loss of visual acuity can result either from the sequelae of proliferative retinopathy or from maculopathy. During the last few years reports have been published showing the effectiveness of photocoagulation for proliferative retinopathy, especially when the optic disc is involved.'-4 There is much less evidence about the efficacy of treatment in diabetic maculopathy.There are only 3 previous reports on randomised controlled studies of diabetic maculopathy.5-7 None of these followed up the patients for longer than 3 years. In our present paper we are reporting the results of treatment for diabetic maculopathy with xenon arc photocoagulation in the British Multicentre Study at a time when an important number of patients have been followed up for 5 years.

Diabetic maculopathy in a Jamaican population

“…Screening of 178 black patients attending the diabetic clinic of the University Hospital of the West Indies, Kingston, described severe visual loss (~< 2/ 60) in 11% of eyes, maculopathy being responsible for 53% of these cases [5]. Photocoagulation has been recommended for diabetic maculopathy [1,3,7,9], however the detection of treatable cases can be difficult as patients often present with advanced maculopathy with irreversible visual loss. This study was designed to assess the prevalance and risk factors for maculopathy in an unselected sample of black Jamaicans with maturity onset diabetes (i.e.…”

Effect of macular photocoagulation on visual acuity of Omani patients with clinically significant macular edema

“…[ 7 8 ] Early efforts at treating macular edema with laser before significant visual loss occurs yielded favorable results. The literature review of similar photocoagulation studies in DME such as Olk et al .,[ 12 13 ] the British multicenter study group,[ 14 ] Blankenship[ 15 ] and ETDRS research group,[ 5 ] has shown that macular photocoagulation is effective in treating macular edema and in stabilizing vision. [ 7 ] ETDRS showed that photocoagulation decreased persistent macular edema and significant visual loss by 50%.…”

A Study on the Short Term Effects of Grid Laser Photocoagulation and Combination Treatment (Grid Laser With Intravitreal Bevacizumab) in the Management of Diabetic Macular Oedema

“…They concluded that intra vitreal Avastin helps decrease macular oedema even when other treatments have failed. (21) In another land mark study, the Pan American collaborative study group (PANCORES) studied the effect of primary intravitreal Avastin in diffuse macular oedema. At the end of two-year follow-up, the number of mean injections required was 5.8 with stability being documented in terms of BCVA and OCT at the end of 24 months.…”