THE EFFECT OF PATIENT CHARACTERISTICS ON RESPONSE TO FOCAL LASER TREATMENT FOR DIABETIC MACULAR EDEMA

Purpose: The purpose of the study was to determine which patient chara cteristics influence response to focal photocoagulation for clinically significant diabetic macular edema (CSME). Methods: A retrospective c hart review was performed of 547 eyes from 361 patients who were obser ved for at least 1 year (mean, 2.6 +/- standard deviation 1.7 years) a fter surgery. Preoperative patient characteristics were tested for the ir significance in predicting outcome using multiple regression analys is. Results: increasing patient age has a negative effect on visual ou tcome (P = 0.0179). Patients with diet-controlled diabetes show improv ement in mean vision, whereas patients whose diabetes is controlled wi th insulin, oral agents, or both show declines, and these differences are significant (P < 0.0001). Neither cataract surgery before or after focal photocoagulation nor simultaneous panretinal photocoagulation f or patients having concomitant high-risk proliferative retinopathy had a significant effect on outcome. Conclusions: Younger patients with C SME and those with diet-controlled diabetes can be given more favorabl e prognoses. Patients with CSME and high-risk proliferative disease ca n have cost-effective simultaneous focal and panretinal photocoagulati on without adversely affecting visual outcome.