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Grid or focal argon laser photocoagulation for diabetic maculopathy: Results and predictors of visual outcomes

By Pelin Taner, Cengiz Akarsu, Ahmet Ergin and Ece Vural

Abstract

Amaç: Diabetik makulopati nedeniyle argon lazer fotokoagülasyon uyguladığımız olgularımızı değerlendirmek, tedavinin başarısını ve son görmeyi etkileyen faktörleri incelemek. Gereç-Yöntem: Diabetik makulopati nedeniyle argon lazer fotokoagülasyon uyguladığımız 31 hastanın 58 gözü retrospektif olarak incelendi. Tüm olguların tedavi öncesi ve sonrası renkli fundus fotoğrafı ve fundus floresein anjiografisi çekildi. Bunun yanısıra tüm olgular Dahiliye kliniğine konsülte edildi ve açlık kan şekeri, hipertansiyon ve sistemik damar hastalığı incelendi. Fokal makulopati saptanan 30 göze fokal, diffüz makulopati saptanan 28 göze grid tarzı argon lazer uygulandı. Olguların tedavi öncesi ve sonrası görme keskinlikleri değerlendirildi. Bulgular: Otuz yedi gözde (%63.8) nonproliferatif diabetik retinopati, 21 gözde (%36.2) proliferatif diabetik retinopati saptandı. Fokal makula ödemi saptanarak fokal lazer uygulanan hasta grubunda; 12 (% 40) gözde görme keskinliğinde artma, 18 (% 60) gözde korunma belirlenirken, hiçbir gözde görme keskinliğinde azalma izlenmedi. Diffüz makula ödemi saptanarak grid lazer uygulanan hasta grubunda ise görme keskinliğinde 3 gözde (% 10.7) artma, 18 göz de (%64.3) korunma ve 7 gözde (%25) ise azalma saptandı. Açlık kan şekeri yüksek olan olgularda, hipertansiyon ve sistemik damar hastalığının eşlik ettiği olgularda tedaviye yanıtın istatistiksel olarak anlamlı düzeyde düştüğü belirlendi. Sonuç: Diabetik makulopatili olgularda lazer uygulaması sonrasında büyük oranlarda görme korunmaktadır. Sistemik sorunların eşlik ettiği olgularda tedaviye yanıt azalmaktadır.Purpose: To evaluate the results of argon lazer photocoagulation for diabetic maculopathy and to determine the predictors of visual outcome. Methods: Fifty-eight eyes of 31 patients who underwent argon lazer photocoagualtion for diabetic maculopathy were evaluated retrospectively. Routine ophthalmic examination including fluorescein angiography and fundus photography were performed. Blood glucose level and presence of systemic vascular disease and/or hypertension were evaluated from patients' records. Thirty eyes with focal maculopathy were treated with argon green focal photocoagulation and 28 eyes with diffuse maculopathy were treated with argon green grid photocoagulation. Visual improvement, visual loss, and the association between visual outcomes and hypertension or systemic vascular disease were assessed. Results: Thirty seven (% 63.8) eyes had non-proliferative diabetic retinopathy and 21 (% 36.2) eyes had proliferative diabetic retinopathy. However, 12 (% 40) eyes had improved visual acuity, 18 (% 60) eyes had stable visual acuity and no eyes had worsened visual acuity in the focal lazer group. Whereas, 3 (% 10.7) eyes had better, 18 (% 64.3) eyes had stable and 7 (% 25) eyes had worse visual acuity after grid lazer photocoagulation in the diffuse maculopathy group. If hypertension and systemic vascular disease were associated with macular edema, there were a significant decline in the outcomes after lazer photocoagulation. Conclusions: The results of our study support previously published reports, suggesting the beneficial effects of grid or focal lazer photocoagulation in diffuse or focal macular edema. The treatment greatly maintain pretreatment visual acuity. But, we found statistically significant association between systemic problems, systemic vascular disease and bad visual outcomes

Topics: Göz Hastalıkları
Year: 2001
OAI identifier: oai:acikerisim.kku.edu.tr:20.500.12587/967
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