Photocoagulation of diabetic macular oedema - complications and visual outcome

Purpose: To describe complications and visual outcome of photocoagulation f or clinically significant macular oedema, Subjects and Methods: Evaluation of macular oedema and complications of pho tocoagulation in 194 eyes, defined as subretinal fibrosis, atrophic creep o f the pigment epithelium and subretinal neovascularization was based on ste reo fundus photo grading. The study included 25 patients with type 1 and 93 patients with type 2 diabetes (age 32+/-10 and 65+9 years, respectively), The statistical evaluations were based on one eye per patient, Results: Follow-up time was 5.5+/-2.4 years (mean+/-SD). Complications with in 1/3 ODD from the centre of the macula were seen in 4% (1/23) of eyes of patients with type 1 diabetes, compared to 26% (20/76) of eyes among patien ts with type 2 diabetes (p=0.02), Hard exsudates before treatment mere more common in type 2 than in type 1 diabetic eyes, 70/82 vs. 11/23 (p<0.001), In all eps, hard exsudates were more often associated with subretinal fibro sis or atrophic creep (35/133 eyes) than diffuse oedema (5/44 eyes) (p=0.04 ), Conclusion: Photocoagulation for clinically significant macular oedema with hard exudates, particularly when subfoveally located, was more often assoc iated,vith subretinal fibrosis or atrophic creep of the pigment epithelium than photocoagulation of oedema without hard exudates, Hard exudates as web as complications after photocoagulation were more common ill type 2 than i n type 1 diabetes, resulting in poorer visual outcome in this group of pati ents.