Razo-Blanco-Hernández DM, Cuan M, Lima-Gómez V

Language: Spanish
References: 17
Page: 186-189
PDF size: 569.13 Kb.

ABSTRACT

Purpose. To determine the efficacy of identifying exudates at the papilomacular bundle to detect clinically significant macular edema (CSME) at primary care, in type 2 diabetics. Method. An observational, prospective, analytic, cross sectional and open study was conducted. Type 2 diabetic patients of any gender, aged 40 70 years, with diabetic retinopathy and CSME were evaluated. Macular edema was assessed diagnosed by biomicroscopy by a retina specialist, and the presence of exudates in the papilomacular bundle in digital photographs as a surrogate of macular edema, was identified by a general physician. The proportion and 95% confidence intervals of the eyes where exudates were identified by the general physician were calculated. Results. Fifty nine eyes of forty three patients were evaluated. Forty one of the evaluated eyes had exudates in the papilomacular bundle (69.5%, 95% C.I. 57.75 to 81.24). In the remaining 30.5% there were no exudates in the papilomacular bundle, so the macular edema could not be diagnosed. Conclusions. The papilomacular bundle is an area usually evaluated by the general physician, and the exudates, a sign of adjacent edema, are easily observed in the fundus by undilated direct ophthalmoscopy, however, although every eye with exudates was identified, the rate of edema that could be detected by this identification was low. The results suggest that despite exudates are easy to identify at the papilomacular bundle, pupil dilatation is required to diagnose the high rate of clinically significant macular edema that develops outside this structure.

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