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Wydanie 1/2008

Ocena skuteczności standardowej fotokoagulacji laserowej w różnych typach cukrzycowego obrzęku plamki

Efficacy Assessment of Standard Laser Treatment in the Different Types of Diabetic Maculopathy

Agnieszka Nowosielska, Iwona Grabska-Liberek

Oddział Kliniczny Okulistyki Centrum Medycznego Kształcenia Podyplomowego w Warszawie Samodzielny Publiczny Szpital Kliniczny im. prof. W. Orłowskiego w Warszawie P. o. kierownik: dr hab. n. med. Iwona Grabska-Liberek

Summary: Clinically significant macular edema (CSME) due to the diabetic retinopathy is one of the leading cause of blindness. Since Early Treatment Diabetic Retinopathy Study Group (ETDRS) reports were published laser treatment is the golden standard of its treatment.
Purpose: The aim of this paper was to assess the efficacy of the standard ETDRS laser treatment performed in the different types of diabetic maculopathies. The treatment efficacy was assessed based on clinical presentation of macular region and vision changes 3 months after laser treatment was performed.
Material and Methods: The medical data of 146 eyes of 73 patients with CSME treated with standard laser phothocoagulation was analyzed. Focal and diffuse maculopathies were noted in 44% of cases and CMO in 12% of cases. In the case of focal maculopathy focal laser treatment was performed. In cases of diffuse and CMO maculopathy grid laser treatment was done.
Results: The efficacy of standard EDTRS laser treatment assessed for whole study group was 50%. However there were differences in treatment efficacy for focal, diffuse and CMO maculopathies. They were respectively 71.9%, 36.9%, 17.6%.
If laser treatment results were assessed based on visual acuity changes it was revealed that treatment stabilized visual acuity mostly in cases of focal maculopathy. In cases of diffuse maculaopathy and CMO there was gradual tendency to VA decline noted.
Conclusions: Standard laser treatment is the most effective in cases of focal maculopathy.
The great number of diffuse maculaopthies and CMOs remains unresponsive to the treatment or despite the clinical improvement VA shows decline.

Keywords: clinically significant macular edema, diabetic maculopathy, diabetes mellitus, diabetic retinopathy, laser photocoagulation, local laser treatment, grid laser treatment.

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