PT  - JOURNAL ARTICLE
AU  - Michel Paques
AU  - Elise Philippakis
AU  - Clémence Bonnet
AU  - Sabrina Falah
AU  - Sarah Ayello-Scheer
AU  - Stéphanie Zwillinger
AU  - Jean-François Girmens
AU  - Benedicte Dupas
TI  - Indocyanine-green-guided targeted laser photocoagulation of capillary macroaneurysms in macular oedema: a pilot study
AID  - 10.1136/bjophthalmol-2015-308142
DP  - 2017 Feb 01
TA  - British Journal of Ophthalmology
PG  - 170--174
VI  - 101
IP  - 2
4099  - http://bjo.bmj.com/content/101/2/170.short
4100  - http://bjo.bmj.com/content/101/2/170.full
SO  - Br J Ophthalmol2017 Feb 01; 101
AB  - Aims In longstanding diabetic macular oedema (DME) or retinal vein occlusion (RVO), capillary macroaneurysms may develop. Indocyanine green angiography (ICGA) has been shown to optimise their detection. Here, we report the anatomical and functional outcome of the elective photocoagulation of capillary macroaneurysms.Methods A retrospective, interventional, two-centre study. In eyes with chronic macular oedema and severe hard exsudates due to diabetic retinopathy or RVO, the presence of capillary macroaneurysms (defined by a diameter larger than 150 µm) was assessed by ICGA and optical coherence tomography (OCT). Capillary macroaneurysms were selectively photocoagulated, the presence of photothrombosis within the lumen being assessed by immediate OCT.Results Four eyes from three patients with DME and five eyes from five 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 capillary macroaneurysms per eye was 2 (range, 1–8) and their median size was 410 µm (range, 154–603). Six months after photocoagulation, there was a significant reduction in macular thickness (mean±SD, 528 µm±200 vs 271 µm±152, p<0.05) and improvement of VA (mean log MAR, 0.82 vs 0.58, p<0.05).Conclusions During macular oedema with severe hard exsudates due to DME or RVO, systematic detection of capillary macroaneurysms by ICGA followed by their OCT-controlled photocoagulation may be of interest. These results may contribute to re-evaluate the role of photocoagulation in the management of longstanding macular oedema.