The authors reviewed the data of 226 eyes in 124 patients with clinically significant diabetic macular edema treated by grid pattern photocoagulation from 1986 to 1994 at the Ophthalmological Clinic of Innsbruck University Hospital. On the basis of baseline visual acuity (VA), eyes were classified in four groups: group 1 = VA < 0.1; group 2 = VA 0.1-0.2; group 3 = VA > 0.2-0.5; group 4 = VA > 0.5. The development of VA from the baseline examination until the last checkup in treated eyes is reported. This classification showed a better visual outcome after photocoagulation in eyes with a decreased VA at baseline (groups 1, 2) compared with eyes with a good initial VA (groups 3, 4). The difference in visual outcome between the second and third groups as well as between the third and fourth groups was statistically significant (p < or = 0.001). A correlation of initial VA with visual outcome after treatment was demonstrated (R = -0.558; p = 0.0001). Clinical conclusions of these results are discussed.