2015, Number 1
<< Back Next >>
Rev Invest Clin 2015; 67 (1)
Retinal Thickness After Focal Photocoagulation For Diabetic Macular Edema With and Without Temporal Perifoveal Thickening
Lima GV, Razo Blanco-Hernández DM, García RYZ, Sánchez MPA
Language: English
References: 23
Page: 25-32
PDF size: 209.61 Kb.
ABSTRACT
Background: Visual improvement after focal photocoagulation in diabetic macular edema is more common in eyes without
temporal perifoveal thickening. This feature is related to a lower macular volume before treatment; the higher proportion of
visual improvement could be associated with a shorter need of volume reduction.
Objective: To compare macular volume before
and after focal photocoagulation in eyes with diabetic macular edema, with and without temporal perifoveal thickening.
Methods:
Non-experimental, retrospective, longitudinal, comparative study in diabetics with macular edema treated with focal photocoagulation.
Macular volume measured with optical coherence tomography, and best corrected visual acuity were compared between
eyes with (group 1) and without temporal perifoveal thickening (group 2, independent samples Student’s t test). The comparison
was also performed after stratifying the groups by baseline visual acuity.
Results: One hundred and twenty eyes, 65 eyes from
group 1 (54.2%) and 55 from group 2 (45.8%). Mean volume before and after treatment and mean absolute and percentage
changes were lower in group 2 (p ‹ 0.001) regardless of visual acuity. Macular volume decreased significantly in eyes of group
1; only eyes in group 2 with visual acuity ‹ 0.5 before treatment increased their visual function (p ‹ 0.001).
Conclusions: Eyes
without temporal perifoveal thickening had visual improvement, although their volume did not change statistically. The significant
volume reduction in eyes with temporal perifoveal thickening was not associated to visual improvement. The anatomical change
was not enough to explain the functional improvement.
REFERENCES
Kollias AN, Ulbig MW. Diabetic retinopathy: Early diagnosis and effective treatment. Dtsch Arztebl Int. 2010;107:75-83.
Josifova T, Schneider U, Henrich PB, Schrader W. Eye disorders in diabetes: potential drug targets. Infect Disord Drug Targets. 2008;8:70-5.
Yau JW, Rogers SL, Kawasaki R, et al. Global prevalence and major risk factors of diabetic retinopathy. Diabetes Care. 2012; 35:556-64.
Varma R, Choudhury F, Klein R, Chung J, Torres M, Azen SP. Four-year incidence and progression of diabetic retinopathy and macular edema: the Los Angeles Latino Eye Study. Am J Ophthalmol. 2010;149:752-61.
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.
American Academy of Ophthalmology Retinal Panel. Preferred Practice Patterns Guidelines. Diabetic retinopathy. San Francisco, CA: American Academy of Ophthalmology; 2008 (4th printing 2012).
Danis RP, Scott IU, Qin H, 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;30:1627-37.
Shrestha A, Khadka D, Karmacharya A, et al. Is laser photocoagulation still effective in diabetic macular edema? Assessment with optical coherence tomography in Nepal. Int J Ophtalmol. 2012;5:217-21.
Zaidi ZA, Jacob MK. Effect of macular photocoagulation on visual acuity of Omani patients with clinically significant macular edema. Oman J Ophthalmol. 2009;2:62-6.
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;123:1330-7.
Lima-Gómez V, Razo Blanco-Hernández DM. Características asociadas con la mejoría visual después de la fotocoagulación en edema macular diabético. Cir Cir. 2012;80:311-9.
Razo Blanco-Hernández DM, Romero-Vargas DM, Bermúdez- Zapata DA, Lima-Gómez V. Modificación del volumen macular por engrosamiento del área temporal, en edema macular diabético focal. Rev Hosp Jua Mex. 2011;78:146-51.
Polito A, Del Borrello M, Polini G, Furlan F, Isola M, Bandello F. Diurnal variation in clinically significant diabetic macular edema measured by the Stratus OCT. Retina. 2006;26:14-20.
Sadda SR, Wu Z, Walsh AC, et al. Errors in retinal thickness measurements obtained by optical coherence tomography. Ophthalmology. 2006;113:285-93.
Lima-Gómez V, Osornio-Castro NA. Comparación del grosor retiniano en diabéticos sin retinopatía, con y sin fondo coroideo. Rev Mex Oftalmol. 2006;80:301-5.
Browning DJ, Glassman AR, Aiello LP, et al. Optical coherence tomography measurements and analysis methods in optical coherence tomography studies of diabetic macular edema. Ophthalmology. 2008;115:1366-71.
Browning DJ, Glassman AR, Aiello LP, et al. Relationship between optical coherence tomography-measured central retinal thickness and visual acuity in diabetic macular edema. Ophthalmology. 2007;114:525-36.
Browning DJ. Interobserver variability in optical coherence tomography for macular edema. Am J Ophthalmol. 2004;137: 1116-17.
Vemala R, Koshy S, Sivaprasad S. Qualitative and quantitative OCT response of diffuse diabetic macular oedema to macular laser photocoagulation. Eye. 2011;25:901-8.
Browning DJ. Interpreting thickness changes in the diabetic macula: the problem of short-term variation in optical coherence tomography–measured macular thickening (an american ophthalmological society thesis). Trans Am Ophthalmol Soc. 2010;108:62-76.
Krzystolik MG, Strauber SF, Aiello LP, Beck RW, Berger BB, Bressler NM. Reproducibility of macular thickness and volume using Zeiss optical coherence tomography in patients with diabetic macular edema. Ophthalmology. 2007;114:1520-5.
Hudson C, Flanagan JG, Turner GS, Chen HC, Rawji MH, McLeod D. Exaggerated relative nasal-temporal asymmetry of macular capillary blood flow in patients with clinically significant diabetic macular oedema. Br J Ophthalmol. 2005;89:142-6.
Holm K, Lövestam AM. In diabetic eyes, multifocal ERG reflects differences in function between the nasal part and the temporal part of the macula. Graefes Arch Clin Exp Ophthalmol. 2012; 250:1143-8.