Junaid Faisal Wazir, Fahad Ghayyur, Zahid Jadoon.
Visual Outcome in patients Treated for Clinically Significant Macular Edema (CSME).
Ophthalmol Update Jan ;15(4):344-7.

Purpose: To evaluate the visual outcome of patients treated for clinically significant macular edema. Study Design: In this interventional quasi experimental technique was adopted. Place and Duration of Study: Vitreo-retina clinic eye OPD, Hayatabad Medical Complex, Peshawar, for a period of 6 months. Material and Methods: It was interventional hospital based study, after quasi experimental sampling technique. Data was collected in vitreo retinal clinic of Eye OPD Hayatabad Medical Complex. All the patients with diabetes were included. Complete visual assessment, ocular slit lamp examination and fundus examination were carried out according to the performa before and after intervention. Those patients who were diagnosed with diabetic macular edema were taken as sample. Grading of diabetic retinopathy was done according to modified Airlie House Classification adopted and modified by Early Treatment Research Group.1 Results: Diabetic retinopathy (DR) was found in 22% of 742 diabetic patients in which 35% (256) had sight threatening diabetic retinopathy. Laser was advised in 95% (243) individuals, accepted by 72% (174) individuals. Amongst 174 patients, 236 eyes had CSME, grid laser was done in 155 eyes (66%) and focal laser was done in 18 eyes (8%) and anti VEGF (intra vitreal avastin) was given in 63 eyes (26%). All patients completed 3 months of follow-up with a mean follow-up period of 5.12�2.59 months. It was found that best corrected visual acuity had declined in 15 eyes 5%, stabilized in 153 eyes (65%) and improved in 75 eyes (30%). Conclusion: Laser therapy and intravitreal avastin injection resulted in significant improvement in BCVA in patients with CSME and this beneficial effect persisted for up to 3months. However, the slight reduction in this improvement at 3 months suggests that repeated intervention might be necessary. To evaluate the long-term safety and efficacy, further prospective randomized controlled clinical trials will be needed.

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