medigraphic.com

2013, Number 6

<< Back Next >>

Cir Cir 2013; 81 (6)

Foveal sensitivity after focal photocoagulation in eyes with diabetic macular edema

Razo-Blanco HDM, Franco-Yáñez Y, Velázquez-Mercado M, Lima-Gómez V

Language: Spanish
References: 31
Page: 478-484
PDF size: 447.34 Kb.


ABSTRACT

Background: Clinically significant macular edema is a common cause of visual loss in diabetics and can reduce macular sensitivity, regardless of visual acuity and retinal thickness. Photocoagulation reduces the risk of visual loss, but may affect the sensitivity in the site of treatment; the effect could improve global macular sensitivity.
Objective: To identify the change of foveal sensitivity in clinically significant macular edema after focal photocoagulation.
Methods: A non-experimental, analytic, longitudinal, prospective study was conducted in diabetics with clinically significant macular edema, treated with photocoagulation. Anatomical, foveal sensitivity and visual acuity changes after treatment were compared between eyes with central thickening (group 1) and without it (group 2); and with visual acuity ≤ 0.5 (group A) and ‹ 0.5 (B, Mann-Whitney’s U); topical treatment after photocoagulation was evaluated as a secondary variable.
Results: 37 eyes, mean age 59.4 years. 12 eyes were assigned to group 1 and 25 to group; 20 eyes were allocated in group A and 17 in group B, 10 eyes received ketorolac, one was treated with nepafenac and 26 with artificial tears. The anatomical, visual acuity and foveal sensitivity variables did not change either in the sample, or between groups. Foveal sensitivity decreased in eyes treated with artificial tears and increased in eyes treated with ketorolac, these outcomes caused a difference of mean sensitivity change (-1.96 vs 1.7 dB, p= 0.026).
Conclusion: Foveal sensitivity decreased significantly after treatment. The change, which was unnoticed in the sample, could be inflammation mediated. The outcome in eyes treated with ketorolac needs additional evaluation.


REFERENCES

  1. Ryan S, Hinton D, Schachat A, Wilkinson C. Retina. 4th ed. St. Louis: Mosby-Yearbook, 2008 p. 1241-1322.

  2. Asociación Mexicana de Retina, Sociedad Mexicana de Oftalmología, Asociación Panamericana de Oftalmología. Resultados del Día Panamericano de detección de retinopatía diabética (3 de julio de 1999, día “D”). Rev Mex Oftalmol. 2005;79:88-92.

  3. Danis RP, Scott IU, Qin H, Altaweel MM, Bressler NM, Bressler SB, et al. Association of Fluorescein Angiographic Features with Visual Acuity and with Optical Coherence Tomographic and Stereoscopic Color Fundus Photographic Features of Diabetic Macular Edema in a Randomized Clinical Trial. Retina. 2010;30(10):1627-1637.

  4. Voo I, Mavrofrides EC, Puliafito CA. Clinical applications of optical coherence tomography for the diagnosis and management of macular diseases. Ophthalmol Clin North Am. 2004;17(1):21-31.

  5. Rohrschneider K, Bültmann S, Springer C. Use of fundus perimetry (microperimetry) to quantify macular sensitivity. Prog Retin Eye Res. 2008;27(5):536-548.

  6. Simó R, Hernández C, European Consortium for the Early Treatment of Diabetic Retinopathy. Neurodegeneration is an early event in diabetic retinopathy: therapeutic implications. Br J Ophthalmol. 2012;96(10):1285-1290.

  7. Vujosevic S, Midena E, Pilotto E, Radin PP, Chiesa L, Cavarzeran F. Diabetic Macular Edema: Correlation between Microperimetry and Optical Coherence Tomography Findings. Invest Ophthalmol Vis Sci. 2006;47(7):3044-3051.

  8. Okada K, Yamamoto S, Mizunoya S, Hoshino A, Arai M, Takatsuna Y. Correlation of retinal sensitivity measured with fundus-related microperimetry to visual acuity and retinal thickness in eyes with diabetic macular edema. Eye (Lond). 2006;20(7):805-809.

  9. Verma A, Rani PK, Raman R, Pal SS, Laxmi G, Gupta M, et al. Is neuronal dysfunction an early sign of diabetic retinopathy? Microperimetry and Spectral Domain Optical Coherence Tomography (SD-OCT) Study in individuals with diabetes, but no diabetic retinopathy. Eye (Lond). 2009;23(9):1824-1830.

  10. Hatef E, Colantuoni E, Wang J, Ibrahim M, Shulman M, Adhi F, et al. The Relationship Between Macular Sensitivity and Retinal Thickness in Eyes With Diabetic Macular Edema. Am J Ophthalmol. 2011;152(3):400-405. E2.

  11. Hudson C, Flanagan JG, Turner GS, Chen HC, Young LB, McLeod D. Influence of laser photocoagulation for clinically significant diabetic macular oedema (DMO) on short-wavelength and conventional automated perimetry. Diabetologia. 1998;41(11):1283-1292.

  12. Greenstein VC, Chen H, Hood DC, Holopigian K, Seiple W, Carr RE. Retinal Function in Diabetic Macular Edema after Focal Laser Photocoagulation. Invest Ophthalmol Vis Sci. 2000;41(11):3655-3664.

  13. Lima-Gómez V, Razo Blanco-Hernández DM. Características asociadas con la mejoría visual después de la fotocoagulación en edema macular diabético. Cir Cir. 2012;80(4):311-319.

  14. Aiello LP, Edwards AR, Beck RW, Bressler NM, Davis MD, Ferris F, et al. Factors Associated with Improvement and Worsening of Visual Acuity 2 Years after Focal/Grid Photocoagulation for Diabetic Macular Edema. Ophthalmology. 2010;117(5):946-953.

  15. American Academy of Ophthalmology. Retina Panel. Preferred practice patterns. Diabetic Retinopathy. San Francisco: American Academy of Ophthalmology, 2008.

  16. Lövestam-Adrian M, Agardh E. Photocoagulation of diabetic macular oedema; complications and visual outcome. Acta Ophthalmol Scand. 2000;78(6):667-671.

  17. Lima-Gómez V, Razo Blanco-Hernández DM, Asbun-Bojalil A. Efecto de la fotocoagulación focal sobre el grosor del punto central en edema macular diabético. Cir Cir. 2011;79(5):395-401.

  18. Striph GG, Hart WM Jr, Olk RJ. Modified grid laser photocoagulation for diabetic macular edema. The effect on the central visual field. Ophthalmology. 1988;95(12):1673-1679.

  19. Rohrschneider K, Bültmann S, Glück R, Kruse FE, Fendrich T, Völcker HE. Scanning laser ophthalmoscope fundus perimetry before and after laser photocoagulation for clinically significant diabetic macular edema. Am J Ophthalmol. 2000;129(1):27-32.

  20. Deák GG, Bolz M, Ritter M, Prager S, Benesch T, Schmidt-Erfurth U, et al. A Systematic Correlation between Morphology and Functional Alterations in Diabetic Macular Edema. Invest Ophthalmol Vis Sci. 2010;51(12):6710-6714.

  21. Photocoagulation for diabetic macular edema. Early Treatment Diabetic Retinopathy Study report number 1. Early Treatment Diabetic Retinopathy Study research group. Arch Ophthalmol. 1985;103(12):1796-1806.

  22. Vujosevic S, Pilotto E, Bottega E, Benetti E, Cavarzeran F, Midena E. Retinal Fixation Impairment In Diabetic Macular Edema. Retina. 2008;28(10):1443-1450.

  23. Polito A, Del Borrello M, Isola M, Zemella N, Bandello F. Repeatability and Reproducibility of Fast Macular Thickness Mapping With Stratus Optical Coherence Tomography. Arch Ophthalmol. 2005;123(10):1330-1337.

  24. Lima-Gómez V. Comparación del grosor macular con y sin edema en pacientes diabéticos mexicanos. Rev Mex Oftalmol. 2007;81(4):214- 218.

  25. Browning DJ, Glassman AR, Aiello LP, Beck RW, Brown DM, Fong DS, et al. Relationship between optical coherence tomographymeasured central retinal thickness and visual acuity in diabetic macular edema. Ophthalmology. 2007;114(3):525-536.

  26. Razo Blanco-Hernandez DM, Lima-Gómez V. Reducción de la sensibilidad foveal en la retina no engrosada en ojos con edema macular diabético. Boletín Informativo CCINSHAE. 03-Jun 2013:57-58.

  27. Sims LM, Stoessel K, Thompson JT, Hirsch J. Assessment of Visual-Field Changes before and after Focal Photocoagulation for Clinically Significant Diabetic Macular Edema. Ophthalmologica. 1990;200(3):133-141.

  28. Ludwig K, Lachenmayr BJ, Bonnici M, Plachta O. Changes in the visual field in diabetic retinopathy after grid laser coagulation of the posterior pole of the eye. Fortschr Ophthalmol. 1991;88(6):824- 828.

  29. Bengtsson B, Heijl A, Agardh E. Visual fields correlate better than visual acuity to severity of diabetic retinopathy. Diabetologia. 2005;48(12):2494-2500.

  30. Nonaka A, Kiryu J, Tsujikawa A, Yamashiro K, Nishijima K, Kamizuru H, et al. Inflammatory Response after Scatter Laser Photocoagulation in Nonphotocoagulated Retina. Invest Ophthalmol Vis Sci. 2002;43(4):1204-1209.

  31. Lewis H, Ryan SJ. Medical and surgical retina. St Louis: Mosby- Yearbook, 1994 p. 251-261.




2020     |     www.medigraphic.com