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Subthreshold laser treatment for retinal arterial macroaneurysm
  1. M Battaglia Parodi1,
  2. P Iacono2,
  3. G Ravalico3,
  4. F Bandello1
  1. 1Department of Ophthalmology, University Vita-Salute, Scientific Institute San Raffaele, Milano, Italy
  2. 2Fondazione GB Bietti per l'Oftalmologia, IRCCS (Istituto di Ricovero e Cura a Carattere Scientifico), Roma, Italy
  3. 3Clinica Oculistica, University of Trieste, Trieste, Italy
  1. Correspondence to Dr Francesco Bandello, Department of Ophthalmology, University Vita-Salute, Scientific Institute San Raffaele, Via Olgettina 60, Milano 20132, Italy; francesco.bandello{at}


Purpose To assess the effects of subthreshold laser treatment (STLT) for retinal arterial macroaneurysms (RAM) associated with foveal exudative manifestations and visual acuity deterioration.

Methods Patients with RAM associated with foveal exudative manifestations and best-corrected visual acuity (BCVA) worse than 20/80 Snellen equivalent underwent a ophthalmological examination, including ETDRS visual acuity, optical coherence tomography (OCT) and fluorescein angiography. The patients were prospectively observed for 4 months, and in absence of spontaneous improvement, they underwent STLT using an infrared diode laser.

Results Primary outcome measures were a reduction in mean central point thickness (CPT) and BCVA changes at the 12-month examination. Secondary outcomes included changes in mean total macular volume (TMV) and central subfield thickness (CST). Nine patients were enrolled and prospectively followed up. The mean baseline values of BCVA, CPT, TMV and CST were 0.8±0.1 (logMAR±SD), 340±49 μm, 7.14±0.05 mm3 and 366±37 μm, respectively. At the 4-month examination following STLT, the mean BCVA improved to 0.6±0.2, whereas the mean CPT, TMV, and CST decreased to 274±29 μm, 6.87±0.11 mm3 and 296±33 μm. At the 12-month examination, the mean BCVA was 0.36±0.2, the mean CPT was 195±11 μm, the mean TMV was 6.55±0.19 mm3, and the mean CST was 239±14 μm, respectively. No side-effects were noted. In particular, no sign of retinal thinning and underlying backscattering typical of conventional laser treatment could be detected at the site of the laser application on OCT.

Conclusion The current pilot investigation of STLT for the treatment of symptomatic RAM revelas encouraging data. A randomised clinical trial is required to ascertain the real efficacy of this technique and the most appropriate settings to be employed.

  • Retina
  • macula
  • treatment
  • lasers

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  • Competing interests None.

  • Patient consent Obtained.

  • Ethics approval Ethics approval was provided by Ospedale S Maria della Misericordia, Udine, Italy and Ospedale Maggiore, Trieste, Italy.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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