Management of diabetic Macular oedema [abstract]

ABSTRACT

Diabetic Macular odema, defined as retinal thickening within a one disc diameter of the centre of the macular, is present in about 10 percent of all patients with diabetes mellitus, and is one of the major potential threats to vision from diabetic retinopathy. The odema may be focal, with leakage primarily from retinal capillary microaneurysms and often associated with hard exudate rings, or diffuse, with wide spread leakage from diffusely dialated capillaries, typically with a cystoid pattern of odema. The importance of recognizing retinal thickening as the diagnostic hallmark of macular odema will be emphasized, and examination techniques to detect retinal thickening will be reviewed. The laser treatment guidelines for clinically significant macular odema recommended by the Early Treatment Diabetic Retinopathy Study (ETDRS), and the preferred methods of administering that treatment, will be described. Options for management of persistent macular odema if the initial laser treatment fails will be discussed, including the use of diamox and others diuretics in the management of selected cases. (AU)