Does conventional laser photocoagulation still have a place in the treatment of diabetic macular edema?

Objective: The study aimed to investigate the long-term efficacy of conventional laser photocoagulation in the treatment of diabetic macular edema. Methods: In this retrospective study, the records of patients presented with diabetic macular edema (DME) and non-proliferative diabetic retinopathy were reviewed. DME defined as clinically significant macular edema was treated by using argon green or yellow dye laser with focal, grid, and modified grid techniques according to Early Treatment Diabetic Retinopathy Study parameters. Best-corrected visual acuity (BCVA) was measured. BCVA change after the treatment and its relationship with other factors were evaluated. Results: The study included 133 eyes of 81 patients. The mean follow-up was 28.26 months. BCVA demonstrated the increase of 2 lines or more in 20.7% of the eyes, stabilization within 2 lines in 60.7% of the eyes, and loss of 2 lines or more in 18.3% of the eyes. The eyes with baseline BCVA lower than or equal to 0.50 showed a statistically significant increase (p=0.001) whereas the eyes with baseline BCVA of more than 0.50 did not show a statistically significant change (p=0.070) after laser photocoagulation treatment. Conclusions: Conventional laser photocoagulation is an effective treatment in diabetic macular edema including center-involved type and stabilizes visual acuity in the majority of the patients. Improvement in BCVA is significant in the group with lower baseline BCVA. Abbreviations: DM = diabetes mellitus, DME = diabetic macular edema, ETDRS = early treatment diabetic retinopathy study, CSME = clinically significant macular edema, CLP = conventional laser photocoagulation, VEGF = vascular endothelial growth factor, BCVA = best-corrected visual acuity, ANOVA = analysis of variance, VA = visual acuity.

Optical coherence tomography in optic pit maculopathy.

PURPOSE: To report the optical coherence tomography (OCT) findings in patients with optic pit maculopathy. METHODS: Twelve eyes of 12 patients with optic pit maculopathy were evaluated. Cross-sectional OCT images were correlated with findings from slit-lamp biomicroscopy and fluorescein angiography. The presence of retinoschisis and serous macular detachment was evaluated and the height of the serous detachment also measured. RESULTS: Visual acuities varied between 20/400 and 20/63. The height of the serous macular detachment at the fovea was between 323 and 548 mum. OCT findings showed that ten (83.3%) patients had both retinoschisis and serous macular detachment, one (8.3%) patient had only retinoschisis and one (8.3%) patient had only serous macular detachment. None of the patients had macular hole or vitreoretinal traction. CONCLUSION: These findings support the concept of a bilaminar structure that contains retinoschisis and serous macular detachment. Our data also showed that in some patients, the sole component of maculopathy was serous macular detachment or retinoschisis.

Intravitreal triamcinolone acetonide for the treatment of cystoid macular edema secondary to Behçet disease.

PURPOSE: To evaluate the safety and effectiveness of intravitreal triamcinolone acetonide in patients with cystoid macular edema (CME) associated with Behçet disease. DESIGN: Interventional case series. METHODS: Ten eyes of 10 patients with CME from Behçet disease made up the study population. All eyes had persistent CME despite medical treatment for at least 2 months. Intravitreal injection of 4 mg (0.1 ml) of triamcinolone acetonide was offered to treat macular edema. The visual and anatomic responses were observed. RESULTS: At 1-month follow-up, a reduction in mean foveal thickness of 37.4%, from 416 microm to 260.5 microm, was attained. At 3-month follow-up, mean foveal thickness was 286.2 microm and at 6 months, 263.7 microm. No eyes had lost vision at 1 month, and eight eyes (80%) showed improvement in visual acuity. At 3-month and 6-month follow-up, three eyes (30%) remained stable and the other eyes had maintained the improved acuity. CONCLUSION: Intravitreal triamcinolone acetonide is a promising therapeutic method for CME from Behçet disease.