Title: A Study on Clinical Effects of Grid Laser Photocoagulation in Diabetic Maculopathy

Authors: Surendran A, Mishra P, Manavalan S, Sridevi V, Ramya M.

 DOI: https://dx.doi.org/10.18535/jmscr/v6i10.168

Abstract

Purpose: To assess the clinical effects of Grid laser photocoagulation in Diabetic macular edema.

Materials & Methods: A total of 100 eyes of 50 patients with Diabetic Macular edema attending the Department of Ophthalmology at Rajah Muthiah Medical College and Hospital, Chidambaram were the target population of the study. Visual acuity for all patients was evaluated by Snellen’s chart. Baseline BCVA was ≥ 6/60.  Macular Grid laser photocoagulation was done for all the patients using 532nm Diode pumped solid state laser (DPSS) delivered by Slit lamp by modified ETDRS criteria. Patients were followed up for a period of 3 months.

Results: Among the 50 patients 26 were Male (52%) and 24 were Female (48%). The mean age of the study population was 55yrs. The mean BCVA BE of the patients; Pre & Post laser showed no change (p > 0.5). On 3 month follow up, 86% of eyes had a stable vision, 4% had improved vision of 1 line and 10% showed decreased vision of 1 line in Snellen’s chart.

Conclusion: Diabetic macular edema is a potentially sight threatening complication of people affected by DM worldwide. Grid laser photocoagulation reduces the risk of moderate vision loss when treated early.

Keywords: Grid laser photocoagulation, Diabetic macular edema, clinically significant macular edema, Diabetes mellitus.

References

  1. International Council of Ophthalmology. Guidelines for Diabetic Eye Care, January 2017
  2. Gadkari SS, Maskati QB, Nayak BK. Prevalence of diabetic retinopathy in India: The All India Ophthalmological Society Diabetic Retinopathy Eye Screening Study 2014. Indian J Ophthalmol 2016;64:38-44.
  3. Early Treatment Diabetic Retinopathy Study Research Group. Photocoagulation for diabetic macular edema. Early Treatment Diabetic Retinopathy Study report number 1. Arch Ophthalmol 1985;103:1796-806.
  4. Early Treatment Diabetic Retinopathy Study Research Group. Photocoagulation for diabetic macular edema: early treatment diabetic retinopathy study report number 4. Int. Ophthalmol. Clin. 27, 265-272 (1987).
  5. McDonald HR, Schatz H. Grid photocoagulation for diffuse macular edema. Retina 5(2), 65–72 (1985).
  6. Pugesgaard T, Laursen AB. Modified grid pattern treatment of diabetic perifoveal edema by orange dye laser photocoagulation. Acta Ophthalmol. Copenh. 66(3), 286–292 (1988).
  7. Lee CM, Olk RJ. Modified grid laser photocoagulation for diffuse diabetic macular edema: long-term visual results. Ophthalmology 98, 1594–1602 (1991).
  8. Akduman L, Olk RJ. Diode laser versus argon green modified grid photocoagulation for diffuse diabetic macular edema. Ophthalmology 1997; 104: 1433–1441.
  9. Tewari HK, Gupta V, Kumar A, Verma L. Efficacy of diode laser for managing diabetic macular oedema. Acta Ophthalmol. Scand. 76(3), 363–366 (1998).
  10. Shahid MJ, Ahmad F, Asif M, Sultan MN. Visual outcome in diabetic macular edema after grid laser treatment. Professional Med J 2016;23(4):478-483.
  11. Shimura M, Yasuda K, Nakazawa T et al. Effective Treatment of Diffuse Diabetic Macular Edema by Temporal Grid Pattern Photocoagulation.Ophthalmic Surg Lasers Imaging 2004; 35:270-280.
  12. Ingrid U. Scott, Ronald P. Danis, Susan B. Bressler. Effect of Focal/Grid photocoagulation on Visual acuity and Retinal thickening in Eyes with Non-center Involved Clinically Significant Macular Edema. Retina. 2009 May ; 29(5): 613-617.

Corresponding Author

Surendran A

Post Graduate, Department of Ophthalmology, Rajah Muthiah Medical College and Hospital, Annamalai University, Chidambaram