Summary:
The authors evaluate group of 111 eyes with diabetic macular edema treated by
laser photocoagulation. The criterion to start laser therapy was biomicroscopically
evident clinical significant macular edema. The visual acuity (VA) is evaluated
during 1 – 5 years after thephotocoagulationwasstarted.Thegroupwithstabilized
VA includes eyes with change of VA up to one line of Snellen optotypes. The groups
with improved or worsened VA include eyes with change of 2 or more lines of
Snellen optotypes. In the first year after the beginning of photocoagulation, VA in
87 eyes (78 %) was stabilized, in 20 eyes (18 %) improved, and in 4 eyes (4 %)
worsened. In the second year after the beginning of photocoagulation, VA in 85
eyes (77 %) was stabilized, in 19 eyes (17 %) improved, and in 7 eyes (6%)worsened.
In the fifth year, VA in 82 eyes (74 %) was stabilized, in 12 eyes (11 %) improved,
and in 17 eyes (15 %) worsened comparing to the findings of first examination. It
is evident from the study, the group with stable VA during the 5 years period
changes a little bit, in the group with improved VA it is a perceptible decline from
18 % to 11 %. The most evident change is seen in the group with worsened VA – here we can notice an interesting conspicuous tendency of doubling the number
of worsened eyes during each two years. Whereas 1 year after the beginning of the
photocoagulation it consists of 4 eyes (4 %) only, two years later, this is in the third
year, it is 9 eyes (8 %), and another two years later, thus 5 years after the beginning
of photocoagulation it is already 17 eyes (15 %). Very important finding is the low
number of eyes in the group with worsenedVA– together 7 (6%) at the examination
performed 2 years after of the photocoagulation has been started because it is
confirmed that in groups without treatment the number of eyes with worsened
VA exceeds 50 %. The photocoagulation near the center of the macula has to be
performed with considerable caution – the authors have the experience that
during several years after the photocoagulation the atrophic lesion enlarges up
to twice its size to the original one, especially in older patients.
Key words:
diabetic maculopathy, macular edema, argon laser and visual acuity
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