[Diabetic maculopathy. Spontaneous course].
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Biomedical subjects
Publications and source records attributed to G Chaine.
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Recent advances in our knowledge concerning spontaneous changes in diabetic retinopathy, and improved classification of clinical forms due to fluorescein angiography, have established precise indications for the use of the laser for retinal photocoagulation in diabetic retinopathy. Controlled, randomized, multicentre studies have conclusively demonstrated the value of the techniques used and results obtained: indirect photocoagulation of the ischaemic zones (pan-retinal photocoagulation) can now effectively preserve the future vision of patients with preproliferating of proliferating retinopathy. The value of photocoagulation in the fight against diabetic oedematous maculopathy appears to be less conclusive, though early elective therapy for juxtafoveolar microvascular lesions appears to be a significant advance.
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The beneficial effects of Argon laser panretinal photocoagulation for diabetic retinopathy complications in decreasing the incidence of blindness were established almost twenty years ago by a multicentric study (Diabetic Retinopathy Study). Every eye presenting with neovascular proliferation either on the disc or elsewhere should be treated with panretinal photocoagulation. Diabetic maculopathy, and mainly cystoid macular edema is the main cause of visual loss in diabetic patients. Photocoagulation in the macular area has proven to be effective in the treatment of exudate rings and cystoid macular edema. Visual acuity is either stabilized or improved after Argon laser treatment of diabetic maculopathy.
We report a case of a 42-year-old woman who was referred for diplopia. She appeared to have a convergence retraction syndrome and loss of vertical gaze. The clinical course led to a diagnosis of thromboembolic cerebrovascular event in the region of the posterior commissure on the basis of risk factors such as smoking and oral contraceptive use. The final outcome was rapidly favorable.