Short term visual prognosis after retinal laser photocoagulation for diabetic maculopathy.

Purpose: Retinal photocoagulation can improve the visual prognosis of patients with diabetic maculopathy complicated with clinically significant macular oedema. However, this effect covers a wide variation of visual outcome with some patients improving and other patients worsening several visual acuity steps. Therefore, parameters are needed that can be used to ensure that treatment is modified or avoided in those patients who are at risk of experiencing visual loss.

Methods: The change in visual acuity shortly after laser photocoagulation for diabetic maculopathy was assessed in 95 eyes of 79 patients as a part of a routine quality assessment programme, and was compared to the age at onset of diabetes, the pre-treatment duration of diabetes, the number of retinopathy lesions and the number of laser applications given to treat the maculopathy.

Results: On average visual acuity was unchanged at the post treatment control (mean=-0.04, SD=0.15), however, with a wide variation (range: -0.44 to 0.33). There was no correlation between the change in visual acuity and any of the studied background parameters.

Conclusions: It is concluded that the treatment intervention rather than the general disease state is the main determining factor for the visual prognosis after laser photocoagulation for diabetic maculopathy. Other parameters should be identified to act as a basis for differentiating and improving laser photocoagulation of diabetic maculopathy. One such possible parameter might be the distance of retinopathy lesions and laser applications from the retinal fixation area.