Anu, V (2022) To study the Efficacy of Grid Laser Photocoagulation on Contrast Sensitivity, Visual Fields and Overall Visual Outcome in Patients with Diabetic Macular Edema: Interventional study. Masters thesis, Stanley Medical College, Chennai.
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Abstract
A study was conducted at department of ophthalmology, Government Stanley medical college, Chennai – 600 001 in 102 patients diagnosed with diabetic macular edema. The patients were treated with grid laser and the pre and post grid visual parameters were recorded and compared to test the effect of grid laser on the overall visual outcome. ● In our study, the age of the patients presenting with diabetic macular edema ranged between 41 to 73 years with a mean age being 57.58 years. ● There is a male preponderance of 53%. ● The most common type of NPDR in our study is severe NPDR which accounts to 39.21 % followed by moderate NPDR that accounts to 31.37 % and mild NPDR which accounts for 29.41% ● Out of 102 eyes treated with grid laser, 58 eyes had improvement in BCVA by atleast 1 line, 32 eyes had stable vision and 10 eyes showed worsening by 1 line 2 eyes had worsening by 2 lines. ● The mean difference between the BCVA at baseline and after 3 months of grid laser is 0.11 log MAR units which was found to be a statistically significant improvement. ● A correlation co-efficient of - 0.244 with a P value of 0.133 indicate that there is no significant positive correlation between the visual acuity and contrast sensitivity at 3 months after grid laser. ● Contrast sensitivity function improved in 46 eyes , remained stable in 40 eyes and worsened in 16 eyes at 3 months after grid laser when compared with baseline. ● The mean difference between the contrast sensitivity at baseline and 3 months is 0.09 log units with a P value of <0.0001 which was found to be a statistically significant improvement. ● The colour vision was deficient and severely impaired in most of the patients at baseline and there was no significant change after grid laser. ● The effect of grid laser for CSME on the central 10 º of visual fields appears to be a statistically insignificant change. CONCLUSION: Our study showed that grid laser for CSME plays a definitive role in improving visual acuity as well as contrast sensitivity function. There was a statistically significant improvement in contrast sensitivity and visual acuity at 3 months which are independent of each other. Contrast sensitivity and visual acuity assessment can be used as a sensitive tool to pick up subtle changes in visual outcome and it may also serve as a sensitive indicator to assess the effect of grid laser on diabetic maculopathy. Contrast sensitivity measured with pelli robson chart can also be used widely for routine examination in patients with diabetic macular edema as it can offer important information about the effect of grid laser on the visual outcome and it also measures the visual outcome better than the uniformly high contrast snellen visual acuity chart. The colour vision defect was found in 85 % of the patients with diabetic macular edema before the grid laser and there was no statistically significant change in the colour vision after 3 months of grid laser. We found that the grid laser does not significantly affect the retinal sensitivity. The tools used in this study to assess the effect of grid laser may be used to assess and modify the intensity and duration of laser burn in grid as well as focal retinal or macular lasers so that the optimum intensity and optimum duration can be ascertained. The main limitation of our study is a small sample size and limited study duration.
| Item Type: | Thesis (Masters) |
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| Additional Information: | 221913051 |
| Uncontrolled Keywords: | Efficacy, Grid Laser Photocoagulation, Contrast Sensitivity, Visual Fields, Overall Visual Outcome, Diabetic Macular Edema, Interventional study. |
| Subjects: | MEDICAL > Ophthalmology > MEDICAL > Ophthalmology |
| Depositing User: | Subramani R |
| Date Deposited: | 12 Apr 2021 02:21 |
| Last Modified: | 23 Dec 2023 02:10 |
| URI: | http://repository-tnmgrmu.ac.in/id/eprint/14670 |
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