The quality of evidence is downgraded by study limitations (incomplete outcome reporting).
A Cochrane review [Abstract] 1 included 24 studies with a total of 4422 eyes. Diabetic macular oedema (DMO) is a complication of diabetic retinopathy and one of the most common causes of visual impairment in diabetes. Intravitreal antiangiogenic therapy is now the standard treatment for DMO, but laser photocoagulation is still used in milder or non-central DMO. At one year, people with DMO receiving laser were less likely to lose best-corrected visual acuity (BCVA) compared with no intervention (table T1). There were also favourable effects observed at 2 and 3 years. One study repoerted benefit on partial or complete resolution of clinically significant DMO (table T1). Data on visual improvement, final BCVA, central macular thickness and quality of life were not available. There was low-certainty evidence of no important difference between subthreshold and standard photocoagulation (mean difference in logMAR BCVA -0.02, 95% CI -0.07 to 0.03; 385 eyes; 7 studies).
| Outcomes | Relative effect (95% CI) | Assumed risk - No intervention | Corresponding risk - Laser (95% CI) | No of eyes (studies) Quality of evidence |
|---|---|---|---|---|
| Improvement of BCVA | No studies reported this | |||
| Worsening of BCVA defined as≥ 15 ETDRS letters (Early Treatment of Diabetic Retinopathy Study) | RR 0.42 (0.20 to 0.90) | 116 per 1000 | 67 fewer per 1000 (93 fewer to 12 fewer) | 3703 eyes(4 studies) Moderate |
| Anatomic measures: partial to complete resolution of the macular oedema Follow-up 36 months | RR 1.55 (1.30 to 1.86) | 460 per 1000 | 253 more per 1000 (138 more to 396 more) | 350(1 study) Moderate |
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