Department of Ophthalmology, King's College Hospital NHS Trust, London, UK.
Eye (Lond). 2011 Jul;25(7):851-8; quiz 859. doi: 10.1038/eye.2011.102. Epub 2011 May 13.
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.
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.
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 (>15 letter loss) in the real-life setting of this cohort compared with the clinical trial results of the DRCRN group (27 vs 8%, respectively).
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.
评估糖尿病黄斑水肿（DMO）激光光凝治疗 5 年的视力结果，并在真实环境中研究全身因素与视力结果的关系。
回顾性收集 2003 年至 2004 年间 100 例 2 型糖尿病患者首次接受局灶/格栅黄斑激光光凝治疗临床显著黄斑水肿的平均年度视力结果和全身参数，并与糖尿病视网膜病变临床研究网络（DRCRN 试验）的激光组进行比较，该试验比较了曲安奈德玻璃体腔内注射与激光光凝治疗 DMO 的疗效。主要观察指标包括 5 年内视力（VA）的平均变化以及全身因素对最终视力结果的影响。
在城市内人群的真实环境中，5 年 VA 的平均变化为-5.23。3 年的结果不如临床试验结果，DRCRN 组获得视力（≥15 个字母增益）的人数多于本队列（26 比 9%）。此外，本队列的患者在真实环境中视力丧失（>15 个字母损失）的人数是 DRCRN 组临床试验结果的三倍（分别为 27 比 8%）。
与参与 DRCRN 组临床试验的患者相比，本队列 DMO 患者的视力结果和全身因素的控制较差。
