Author(s): Aiello LP, Edwards AR, Beck RW, Bressler NM, Davis MD, Ferris F, Glassman AR, Ip MS, Miller KM; Diabetic Retinopathy Clinical Research Network. Factors associated with improvement and worsening of visual acuity 2 years after focal/grid photocoagulation for diabetic macular edema. Ophthalmology. 2010 May;117(5):946-53. doi: 10.1016/j.ophtha.2009.10.002. Epub 2010 Feb 1. PMID 20122739
Journal: Ophthalmology, Volume 117, Issue 5, May 2010
PURPOSE To identify factors associated with the visual acuity outcome after focal/grid photocoagulation for diabetic macular edema (DME) among eyes randomized to the focal/grid photocoagulation treatment group within the Diabetic Retinopathy Clinical Research Network (DRCR.net) trial comparing triamcinolone with focal/grid laser.
DESIGN Multicenter, randomized, clinical trial.
PARTICIPANTS Three hundred thirty eyes with DME assigned to the focal/grid photocoagulation group, visual acuity 20/40 to 20/320, and optical coherence tomography (OCT) central subfield thickness > or =250 microns.
METHODS Eyes were treated with a protocol-defined photocoagulation technique, which was repeated at 4-month intervals for persistent or recurrent edema. Separate logistic regression models were used to evaluate the associations of demographic, clinical, OCT, and fundus photographic variables with visual acuity improvement or worsening of > or =10 letters from baseline to 2 years. The association of the initial visual acuity outcome after treatment with the subsequent visual acuity course also was evaluated.
MAIN OUTCOME MEASURES Visual acuity measured with the electronic Early Treatment Diabetic Retinopathy Study method.
RESULTS Worse baseline visual acuity was the only factor found to be associated with more frequent visual acuity improvement (P or =10 letters from baseline to 4 months subsequently improved, and many eyes that initially improved, subsequently worsened.
CONCLUSIONS At this time, focal/grid photocoagulation remains the standard management for DME and these results do not alter this paradigm.
Copyright 2010 American Academy of Ophthalmology. Published by Elsevier Inc. All rights reserved.