Treatment of choice for Clinically Significant Macular Edema in a diabetic is?
Focal Photocoagulation REF: Yanoff & Ducker- ophthalmology 2nd edition page 867, 884 While the Early Treatment Diabetic Retinopathy Study demonstrated the visual benefit of focal photocoagulation for clinically significant macular edema, the CME component does not respond as well to laser photocoagulation. Patz was the first to show that argon laser photocoagulation decreases or stabilizes macular edema. Later, the ETDRS confirmed his results. The ETDRS defined clinically significant macular edema as: Retinal thickening involving the center of the macula Hard exudates within 500 arm of the center of the macula (if associated with retinal thickening) An area of macular edema greater than one disc area but within one disc diameter of the center of the macula The Early Treatment Diabetic Retinopathy Study (ETDRS) also showed that Pan retinal photocoagulation should not be given to eyes with clinically significant macular edema unless high-risk characteristics (HRC) are present
Control of Diabetes
Focal Photocoagulation
Panretinal Photocoagulation
Vitreoretinal Surgery