Optical coherence tomography-guided selective focal laser photocoagulation: a novel laser protocol for diabetic macular edema

Abstract

OCT-laser shows similar anatomic and functional outcomes compared to conventional laser (modified ETDRS), with significantly less retinal damages.

Indocyanine-green-guided targeted laser photocoagulation of capillary macroaneurysms in macular oedema: a pilot study

“…Refining diagnostic and photocoagulation procedures may thus contribute to improve its efficiency. In previous studies of direct photocoagulation of microaneurysms, it has been noted that larger microaneurysms are more difficult to occlude,12 13 hence the interest of monitoring the treatment effect by OCT for capillary macroaneurysms. Therefore, in longstanding macular oedema a systematic screening for these lesions, commonly overlooked on conventional FA, may be of interest, especially in the presence of severe HEs.…”

“…The amphiphilic properties of ICG11 may explain why ICG is more sensitive than the highly hydrophilic sodium fluorescein for the detection of capillary macroaneurysms since it may stain intraluminal fibrinogen. Trials of direct photocoagulation of microaneurysms yielded overall modest results12 13 despite anecdotal favourable results 14. However, since detection of capillary lesions is routinely based on FA, it is likely that many capillary macroaneurysms are not detected.…”

“…Based on our clinical experience and on previous reports of targeted photocoagulation of microaneurysms,12 13 which showed limited benefit of photocoagulation of lesions smaller than 130 µm, we empirically defined photocoagulation targets as capillary macroaneurysms larger than 150 µm. We report here our initial experience of this procedure in cases with severe hard exsudates.…”

New Frontiers in Selective Retinal Lasers

“…Yannis Mantas Paulus 2.5 letters of improved vision (p=0.04) and a 45.56 micron reduction in central subfield thickness (p<0.001) compared to conventional modified Early Treatment Diabetic Retinopathy Study (mETDRS) focal laser at 1 year [19] . Further modifications have been described using laser dosimetry to empirically titrate to barely visible burns.…”

Direct Photocoagulation Guided by Merged Retinal Images for the Treatment of Focal Diabetic Macular Edema

“…MAs located in the thickened area may be associated with DME pathogenesis. Recently, mapping images using spectral domain-optical coherence tomography (SD-OCT) has provided information regarding the degree and distribution of macular thickness [9]. …”