Predictive factors of outcome of selective retina therapy for diabetic macular edema.

Abstract

To investigate the predictive factors of clinical outcome of selective retina therapy (SRT) for diabetic macular edema (DME). This retrospective study included 22 eyes of 22 patients (15 males and 7 females), who were treated with SRT for DME at the Department of Ophthalmology of Osaka City University Hospital and observed at least 6months after the treatment. The mean age was 64years (range 40-81). Thirteen of the 22 eyes (59%) had a treatment history other than SRT before. SRT laser (527nm, 1.7µs, 100Hz) was used for treatment. Changes in the best-corrected visual acuity (BCVA) (logMAR) and central macular thickness (CMT) in optical coherence tomography were examined at baseline, 3-month follow-up, and 6-month follow-up. Factors associated with the rate of change in CMT at 3 and 6months after SRT were examined. The mean BCVA (logMAR) was 0.26 ± 0.31, 0.22 ± 0.27 and 0.23 ± 0.29 at baseline, 3months and 6months, respectively (p = 0.15 at 3months, 0.40 at 6months; compared to baseline). The mean CMT was 502 ± 163, 493 ± 204, and 416 ± 185μm at baseline, 3months, and 6months, respectively (p = 0.69 at 3months, 0.01 at 6months; compared to baseline). The multivariate analysis found a significant negative association with previous macular photocoagulation (p = 0.03) at 3months and a positive association with a history of insulin use (p = 0.02) and previous panretinal photocoagulation (p = 0.03) at 6months after SRT. The CMT was significantly decreased at 6months after SRT in DME. The history of insulin use and panretinal photocoagulation may positively and the history of macular photocoagulation may negatively affect the outcome of SRT, which must be considered when determining the therapeutic indications for SRT.