Visual Outcomes in the Management of Diabetic Maculopathy in Central Australia.
Ophthalmic Epidemiol
; 27(4): 265-271, 2020 08.
Article
en En
| MEDLINE
| ID: mdl-32070176
ABSTRACT
PURPOSE:
In major urban centres and high-resource settings, treatment of diabetic maculopathy with anti-Vascular Endothelial Growth Factor (VEGF) injections has largely displaced laser treatment. However, intravitreal therapy alone requires frequent follow-up, a barrier to adherence in remote Australia. We report vision outcomes of phased diabetic maculopathy treatment in remote Central Australia for maculopathy using laser and, in a subset, supplementary injection treatment.METHODS:
We audited clinical records of patients undergoing laser treatment for diabetic maculopathy between 2001 and 2013 at an ophthalmology service based at Alice Springs Hospital, a regional hub in remote Australia. All patients receiving macular laser treatment were included, and some required supplementary injection(s). The primary outcome measure was change in best-corrected visual acuity [BCVA] from baseline treatment.RESULTS:
Of 338 maculopathy-treated patients, 88% were indigenous and 39% were male. Of 554 maculopathy laser-treated eyes, 118 (21%) received supplementary injection/s. In the laser treatment phase, median BCVA was 78 letters at baseline (interquartile range 62-80) and decreased by a median of two letters at final visit. In the subset who underwent subsequentinjection treatment, BCVA was 60 letters at first injection, with a median five-letter increase by final visit. Overall outcomes were similar in Indigenous and non-Indigenous Australians. Predictors of reduction in BCVA in the macular laser treatment phase were better baseline BCVA, older age, and PRP treatment (all p < .005).CONCLUSION:
Laser treatment for diabetic maculopathy preserved vision in Central Australia, where barriers to follow-up can preclude regular injections. Supplementary injections stabilized vision in the laser-resistant subset.Palabras clave
Texto completo:
1
Base de datos:
MEDLINE
Asunto principal:
Receptores de Factores de Crecimiento Endotelial Vascular
/
Complicaciones de la Diabetes
/
Retinopatía Diabética
/
Terapia por Láser
/
Degeneración Macular
Tipo de estudio:
Diagnostic_studies
/
Etiology_studies
/
Observational_studies
/
Prognostic_studies
/
Risk_factors_studies
País/Región como asunto:
Oceania
Idioma:
En
Revista:
Ophthalmic Epidemiol
Asunto de la revista:
EPIDEMIOLOGIA
/
OFTALMOLOGIA
Año:
2020
Tipo del documento:
Article