September 2016
Volume 57, Issue 12
Open Access
ARVO Annual Meeting Abstract  |   September 2016
Indocyanine green-guided targeted photocoagulation of macroaneurysms in macular edema: a pilot study
Author Affiliations & Notes
  • Benedicte Marie Dupas
    Hospital Lariboisiere, Paris, France
  • Elise Philippakis
    Hospital Lariboisiere, Paris, France
  • serge meimon
    Office National d’Etudes et de Recherches Aéronautiques, Département d’Optique Théorique et Appliquée (ONERA-DOTA, Chatillon, France
  • Clémence Bonnet
    Clinical Investigation Center 1423, Quinze-Vingts Hospital, INSERM & Université Pierre et Marie Curie-Paris, Paris, France
  • Jean-Francois GIRMENS
    Clinical Investigation Center 1423, Quinze-Vingts Hospital, INSERM & Université Pierre et Marie Curie-Paris, Paris, France
  • Michel Paques
    Clinical Investigation Center 1423, Quinze-Vingts Hospital, INSERM & Université Pierre et Marie Curie-Paris, Paris, France
  • Footnotes
    Commercial Relationships   Benedicte Dupas, None; Elise Philippakis, None; serge meimon, None; Clémence Bonnet, None; Jean-Francois GIRMENS, None; Michel Paques, None
  • Footnotes
    Support  NONE
Investigative Ophthalmology & Visual Science September 2016, Vol.57, 3246. doi:
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      Benedicte Marie Dupas, Elise Philippakis, serge meimon, Clémence Bonnet, Jean-Francois GIRMENS, Michel Paques; Indocyanine green-guided targeted photocoagulation of macroaneurysms in macular edema: a pilot study. Invest. Ophthalmol. Vis. Sci. 2016;57(12):3246.

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      © ARVO (1962-2015); The Authors (2016-present)

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Abstract

Purpose : In longstanding diabetic macular edema (DME) or retinal vein occlusion (RVO), large vascular abnormalities may cause macular edema. Indocyanine green angiography (ICGA) has been shown to optimize their detection (Bouhris et al. 2010). Here we report the anatomical and functional outcome of the elective photocoagulation of large microvascular abnormalities, termed here macroaneurysms.

Methods : Retrospective, interventional, two-center study. In patients with chronic macular edema with severe hard exsudates due to diabetic retinopathy or to RVO, the presence of macroaneurysms (defined by a diameter larger than 150µm) was assessed by ICGA and optical coherence tomography (OCT). Macroaneurysms were selectively photocoagulated. Immediate photothrombosis was assessed by post-operative OCT.

Results : Four eyes from 3 patients with DME and 5 eyes from 5 patients with RVO were included. The median duration of visual loss was 4 years. Median initial visual acuity (VA) was 20/200. The median number of macroaneurysms per eye was 2 (range, 1-8) and their mean size was 484µm (range, 154-1800). Six months after photocoagulation, there was a significant reduction of macular thickness (mean± SD, 528µm ± 200 versus 271µm ±152, p<0.05) and improvement of VA (mean logMAR, 0.82 versus 0.58, p<0.05).

Conclusions : During macular edema with severe hard exsudates due to DME or RVO, systematic detection of macroaneurysms by ICGA followed by their OCT-controlled photocoagulation may be very useful. These results may contribute to reevaluate the role of photocoagulation in the management of longstanding macular edema.

This is an abstract that was submitted for the 2016 ARVO Annual Meeting, held in Seattle, Wash., May 1-5, 2016.

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