Scanning laser ophthalmoscope fundus perimetry before and after laser photocoagulation for clinically significant diabetic macular edema

PURPOSE: To prospectively evaluate functional and funduscopic changes after laser treatment in patients with diabetic retinopathy and clinically signi ficant macular edema by scanning laser ophthalmoscope fundus perimetry. METHODS: Thirty eyes of 30 patients with clinically significant macular ede ma as a result of diabetic retinopathy were prospectively examined before a nd at least 3 months after focal laser treatment with automatic fundus thre shold perimetry using the scanning laser ophthalmoscope. Thresholds of ligh t sensitivity were compared with age-corrected normal values and correlated with corrected visual acuity and subjective appraisal of visual function. RESULTS: In 30 eyes, fundus perimetry lasted for 10.5 +/- 2.1 (mean +/- SD) minutes with 322 +/- 67 stimulus presentations for each eye. Whereas eight eyes remained stable (< +/-1 dB change), 15 improved concerning mean devia tion (MD) (3.1 +/- 1.7 dB) after focal laser treatment. Stability of fixati on remained the same after focal laser treatment (0.75 +/- 0.57 degree). La ser scars showed marked loss of function (MD > 13 dB). CONCLUSIONS: Although light sensitivity was reduced in areas of macular ede ma, there was no correlation between the amount of edema and visual functio n. Fundus perimetry allows the creation of exact maps of retinal dysfunctio n before and after laser treatment. It may help in making management decisi ons in diabetic and nondiabetic patients by offering a sensitive parameter in addition to visual acuity. (Am J Ophthalmol 2000; 129:27-32. (C) 2000 by Elsevier Science Inc. All rights reserved.)