Subthreshold laser treatment for retinal arterial macroaneurysm

Parodi, Maurizio Battaglia; Iacono, Pierluigi; Ravalico, Giuseppe; Bandello, Francesco

doi:10.1136/bjo.2009.175547

Cited by 26 publications

(14 citation statements)

References 36 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…16 The underlying STLT mechanism is thought to be related to the effects of the retinal hyperthermia below the cell death threshold, although the details of this interaction remain uncertain. STLT works by reducing the duration of laser exposure and using a subvisible clinical endpoint.…”

Section: Discussionmentioning

confidence: 99%

“…The laser parameters were based on those of our previous study. 16 In particular, the STLT power was arbitrarily set at 1400 mW. Complete laser settings are shown in Table 1.…”

Section: Methodsmentioning

confidence: 99%

“…5 Subthreshold laser treatment (STLT) was recently reported to be effective in achieving the cessation of leakage, associated with functional improvement. 16 The aim of the present study was to compare the effects of TLT and STLT for symptomatic RAM.…”

mentioning

confidence: 99%

See 2 more Smart Citations

Subthreshold Laser Treatment Versus Threshold Laser Treatment for Symptomatic Retinal Arterial Macroaneurysm

Parodi¹,

Iacono

Pierro³

et al. 2012

Invest. Ophthalmol. Vis. Sci.

View full text Add to dashboard Cite

PURPOSE. This study was designed to compare the effects of subthreshold laser treatment (STLT) with threshold laser treatment (TLT) in patients affected by symptomatic retinal arterial macroaneurism (RAM). METHODS.Patients affected by symptomatic RAM, characterized by exudative manifestations involving the fovea and bestcorrected visual acuity (BCVA) worse than 20/80 Snellen equivalent, were recruited. Patients were randomly assigned to STLT or TLT and regularly followed up for 12 months. Primary outcome measures were changes in central point thickness (CPT) at the end of the follow-up. Secondary outcome measures were changes in mean BCVA at the end of the follow-up and identification of postlaser alterations.RESULTS. In this single center, randomized, clinical trial, 12 patients were randomized to STLT and 13 to TLT. CPT in STLT was 332 lm at baseline and changed to 249 lm at the 12-month examination. CPT in TLT was 341 lm and reduced to 226 lm at the end of the follow-up. BCVA in STLT changed from 0.72 logMAR to 0.28 logMAR. BCVA in TLT changed from 0.76 logMAR to 0.26 logMAR. The statistical analyses revealed a significant difference comparing the baseline values for both CPT and BCVA in each subgroup from the third month (P < 0.001). No difference was found comparing the two subgroups at any point in time. Three eyes (23%) treated with TLT developed an epiretinal membrane with subjective metamorphopsia.CONCLUSIONS. This pilot randomized clinical trial shows that both STLT and TLT can achieve similar improvements in BCVA and CPT. The lower laser energy delivered by STLT can reduce the complication rate. (Clinicaltrials.gov number, NCT01301326.) (Invest Ophthalmol Vis Sci.

show abstract

Section: Discussionmentioning

confidence: 99%

“…The laser parameters were based on those of our previous study. 16 In particular, the STLT power was arbitrarily set at 1400 mW. Complete laser settings are shown in Table 1.…”

Section: Methodsmentioning

confidence: 99%

See 1 more Smart Citation

Subthreshold Laser Treatment Versus Threshold Laser Treatment for Symptomatic Retinal Arterial Macroaneurysm

Parodi¹,

Iacono

Pierro³

et al. 2012

Invest. Ophthalmol. Vis. Sci.

View full text Add to dashboard Cite

show abstract

“…The primary management of submacular hemorrhage differs according to the cause of subretinal hemorrhage. Treatments for retinal arterial macroaneurysm include direct laser photocoagulation or simple observation with good visual prognosis [15,16,17]. Submacular hemorrhage from trauma may require pneumatic displacement or pars plana vitrectomy without the use of anti-VEGF agents.…”

Section: Introductionmentioning

confidence: 99%

Identification of Underlying Causes of Spontaneous Submacular Hemorrhage by Indocyanine Green Angiography

Kim

Lee²,

Kim

et al. 2015

Ophthalmologica

View full text Add to dashboard Cite

Purpose: To investigate the causes of acute spontaneous submacular hemorrhage with indocyanine green angiography (ICGA). Methods: Retrospective observation case series. A total of 51 eyes from 51 patients with newly developed spontaneous submacular hemorrhage were enrolled. Best-corrected visual acuity (BCVA), fundus photography, fluorescein angiography, spectral domain optical coherence tomography (OCT), and ICGA at baseline were analyzed. The extent of hemorrhage using fundus photography, height of hemorrhage, and central foveal thickness measured by OCT was analyzed to compare the diagnostic and nondiagnostic groups. Results: The mean logarithm of the minimum angle of resolution (logMAR) BCVA at presentation was 1.21 ± 0.74 (Snellen equivalent, 20/324); the mean follow-up period was 23.9 ± 23.9 months. The cause of submacular hemorrhage was diagnosed in 43 of 51 eyes (84.3%) based on ICGA at presentation. The initial diagnoses were correct in 93% of eyes. In 3 cases, the initial diagnosis of age-related macular degeneration (AMD) was changed to polypoidal choroidal vasculopathy (PCV) based on follow-up ICGA. The central foveal thickness was significantly greater in the nondiagnostic group (1,102.4 vs. 666.7 μm, respectively; p = 0.008). The most common cause of submacular hemorrhage was neovascular AMD (52.9%), followed by PCV (37.3%), macroaneurysm (5.9%), and lacquer crack (3.9%). The mean final visual acuity was generally worse in patients with submacular hemorrhage with typical AMD (visual acuity 20/618) or PCV (visual acuity 20/240) compared to that in patients with retinal macroaneurysm (visual acuity 20/100) or lacquer crack (visual acuity 20/72). Conclusions: ICGA at initial presentation helps identify causes of submacular hemorrhage, allowing differential treatment approaches that may improve outcomes and safety.

show abstract

“…In order to reduce the potential harmful effects of laser photocoagulation and risks of adverse events associated with laser treatment, Parodi M and coauthors suggested micropulse laser therapy of the RAM, which they demonstrated has efficacy equal to conventional laser without the attendant collateral retinal damage [ 8 ].…”

mentioning

confidence: 99%

Direct navigated laser photocoagulation as primary treatment for retinal arterial macroaneurysms

et al. 2018

View full text Add to dashboard Cite

ObjectivesTo compare the efficacy and safety of conventional and navigated laser photocoagulation as the primary treatment option for retinal arteriolar macroaneurysm (RAM).MethodsEleven (9 male and 2 females, mean age 65.1 ± 12.1 years) and 17 (13 male and 4 females, mean age 66.2 ± 8.9 years) patients were included in conventional laser photocoagulation (CLP) and navigated laser photocoagulation (NLP) groups, respectively. The primary outcome measures were LogMAR best-corrected visual acuity (BCVA) and central retinal thickness at the end of the follow-up. The secondary outcome measure was total laser energy applied during the procedure.ResultsAt the end of the mean follow-up of 11.4 ± 4.0 months, baseline LogMAR BCVA increased significantly from 0.65 ± 0.14 to 0.26 ± 0.12 (p < 0.001) in CLP group and from 0.57 ± 0.33 to 0.29 ± 0.34 (p < 0.001) in NLP group. Central retinal thickness decreased significantly from 514.5 ± 53.2 µm to 295.3 ± 11.3 µm (p < 0.001) and from 494.0 ± 111.2 µm to 285.8 ± 51.4 µm (p < 0.001) in CLP and NLP group, respectively. Total laser energy and number of laser burns applied per procedure in NLP group was statistically significantly lower than in CLP group (0.28 ± 0.13 J vs 0.59 ± 0.06 J, p < 0.001 and 28.5 ± 14.2 burns vs 48.9 ± 5.1 burns, respectively, p < 0.001). No adverse events related to laser treatment was noted in study groups during the follow-up.ConclusionThis study demonstrated superiority of navigated laser photocoagulation compared to conventional laser photocoagulation in primary treatment of RAM which results from similar efficacy and safety of both techniques with lower mean total laser energy and number of laser burns required for navigated laser photocoagulation.

show abstract

Subthreshold laser treatment for retinal arterial macroaneurysm

Cited by 26 publications

References 36 publications

Subthreshold Laser Treatment Versus Threshold Laser Treatment for Symptomatic Retinal Arterial Macroaneurysm

Subthreshold Laser Treatment Versus Threshold Laser Treatment for Symptomatic Retinal Arterial Macroaneurysm

Identification of Underlying Causes of Spontaneous Submacular Hemorrhage by Indocyanine Green Angiography

Direct navigated laser photocoagulation as primary treatment for retinal arterial macroaneurysms

Contact Info

Product

Resources

About