Five-year visual outcome following laser photocoagulation of diabetic macular oedema

Objective To evaluate the 5-year visual outcome associated with laser photocoagulation treatment of diabetic macular oedema (DMO), and to investigate the relationship between systemic factors and visual outcomes in a real-life setting. Methods The mean annual visual outcomes and systemic parameters of 100 consecutive subjects with type 2 diabetes who underwent the first session of focal/grid macular laser photocoagulation for clinically significant macular oedema between 2003 and 2004 were collected retrospectively and compared with the outcomes of the laser arm of the Diabetic Retinopathy Clinical Research Network (DRCRN trial comparing intravitreal triamcinolone acetonide injection with laser photocoagulation treatment for DMO). The primary outcome measures included the mean change in visual acuity (VA) in 5 years and the influence of systemic factors on final visual outcome. Results The mean change in VA at 5 years was -5.23 in a real-life setting for an inner city population. The 3-year outcome was inferior to the clinical trial results with more people gaining vision (>= 15 letter gain) in the DRCRN group compared with this cohort (26 vs 9%). Furthermore, three times more patients lost vision (415 letter loss) in the real-life setting of this cohort compared with the clinical trial results of the DRCRN group (27 vs 8%, respectively). Conclusions The visual outcomes and the control of systemic factors of patients with DMO in this cohort were inferior to those recruited for the clinical trial involving the DRCRN group. Eye (2011) 25, 850-859; doi: 10.1038/eye.2011.102; published online 13 May 2011