Lima-Gómez V, Razo-Blanco HDM

Language: Spanish
References: 0
Page: 311-319
PDF size: 175.96 Kb.

ABSTRACT

Background: Photocoagulation reduces the incidence of moderate visual loss in patients with clinically significant macular edema (CSME); however, the incidence of visual improvement after treatment is low; diffuse retinal thickening identified with optical coherence tomography (OCT) and visual loss before treatment have been associated with visual improvement.
Objective: To identify features associated with visual improvement after focal photocoagulation for CSME.
Methods: Observational, analytical, longitudinal, retrospective study. Diabetic patients with CSME treated with focal photocoagulation were evaluated. Study variables were: visual improvement (defined as a gain of one or more lines in a vision chart) and ocular and systemic features before treatment. Clinical and ancillary test variables were compared between eyes with and without visual improvement. Mann-Whitney’s U was used to compare quantitative variables; χ² was used for qualitative variables.
Results: 99 eyes of 72 patients mean age 60.6 years, 59.6% females. 38.4% has visual improvement after treatment. The incidence of visual improvement was higher in eyes with vision ‹ 20/40 before treatment (58.8 vs. 16.7%, p ‹ 0.001, relative risk 3.53). In eyes with vision ≥ 20/40 before treatment, the probability of improving was 12 times higher when field 7 of the OCT map had no thickening (p ‹ 0.001). The remaining variables showed no significant associations.
Conclusions: Up to 48% of treated eyes could achieve visual improvement. Consistently with previous reports, the probability increased in eyes with vision ‹ 20/40 before photocoagulation; when vision before treatment was ⊗ 20/40, the incidence of visual improvement increased significantly in eyes without thickening in the temporal parafoveal retina.