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2011, Número 5

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Cir Cir 2011; 79 (5)


Efecto de la fotocoagulación focal sobre el grosor del punto central en edema macular diabético

Lima-Gómez V, Razo Blanco-Hernández DM, Asbun-Bojalil J

Idioma: Español
Referencias bibliográficas: 37
Paginas: 395-401
Archivo PDF: 568.74 Kb.


RESUMEN

Introducción: El tratamiento estándar del edema macular clínicamente significativo (EMCS) es la fotocoagulación, que reduce el engrosamiento macular si bien se ha informado que no modifica tempranamente el área de mejor función visual.
Objetivo: comparar el efecto de la fotocoagulación focal sobre el grosor del punto central (GPC) y el volumen macular tres semanas después del tratamiento en diabéticos mexicanos con EMCS, con y sin afección del punto central.
Material y métodos: Estudio observacional, retrospectivo, longitudinal, analítico y abierto. Se evaluaron diabéticos tipo 2 con EMCS que requerían fotocoagulación focal. Mediante t pareada se compararon los promedios de GPC y volumen macular antes y tres semanas después del tratamiento en la muestra y en ojos con afección basal del punto central (grupo 1) y sin ella (grupo 2); se identificaron los cambios absolutos y porcentuales de ambas variables.
Resultados: se estudiaron 59 ojos de pacientes con edad promedio de 59.6 años; el promedio del GPC aumentó de 193 a 197 µm (p = 0.3), significativamente en el grupo 2 (168.8 a 178.5 µm, p ‹ 0.001). El promedio de volumen cambió de 7.8 a 7.6 mm3 (p ‹ 0.001). En la muestra el promedio de GPC aumentó 3.9 µm (3%) y el del volumen macular disminuyó 0.26 mm3 (3.1%); la correlación entre estos cambios fue de 0.089.
Conclusiones: Aunque el volumen macular disminuyó significativamente después de la fotocoagulación, el GPC no lo hizo y aumentó significativamente en ojos sin afección basal del punto central, lo cual no se identifica en el efecto de la muestra. El manejo de estos cambios podría mejorar los resultados tempranos del tratamiento.


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