Indocyanine Green Angiography-Guided Focal Laser Photocoagulation for Diabetic Macular Edema

2015 ◽  
Vol 234 (3) ◽  
pp. 139-150 ◽  
Author(s):  
Shuntaro Ogura ◽  
Tsutomu Yasukawa ◽  
Aki Kato ◽  
Soichiro Kuwayama ◽  
Satoshi Hamada ◽  
...  
Keyword(s):  
Indocyanine Green ◽  
Macular Edema ◽  
Diabetic Macular Edema ◽  
Early Phase ◽  
Laser Photocoagulation ◽  
Indocyanine Green Angiography ◽  
Late Phase ◽  
Macular Thickness ◽  
Focal Laser Photocoagulation ◽  
The Mean

Purpose: To evaluate the usefulness of indocyanine green angiography (ICGA) to detect leaking spots and the effectiveness of ICGA-guided focal laser photocoagulation in eyes with diabetic macular edema (DME). Methods: Ten eyes (8 patients) with diffuse DME diagnosed using fluorescein angiography (FA) and refractory to a sub-Tenon injection of triamcinolone acetonide (STTA), grid laser photocoagulation, or both were enrolled. FA and ICGA were performed using the Heidelberg Retina Angiograph 2. Hyperfluorescent spots on early-phase FA and on early- and late-phase ICGA were superimposed onto the macular thickness map measured by optical coherence tomography (OCT) and counted to calculate the spot density in the area with or without macular edema (ME). ICGA-guided focal laser photocoagulation was carried out. In 7 eyes, STTA was simultaneously performed. The central macular thickness (CRT) and macular volume (MV) were measured by OCT. Results: On early-phase FA, 4.8 ± 2.3 and 2.3 ± 1.5 hyperfluorescent spots/disk area were observed inside and outside the ME, respectively. In contrast, the spot density was significantly decreased to 1.8 ± 0.9 inside the ME and was only 0.3 ± 0.4 outside the ME on late-phase ICGA (p < 0.01). The mean follow-up period after ICGA-guided photocoagulation was 19.0 months. The mean best-corrected visual acuity improved significantly from 0.77 ± 0.34 logarithm of the minimum angle of resolution at baseline to 0.52 ± 0.37 at the last visit (p < 0.01). Both CRT and MV significantly decreased (p < 0.01). Recurrence of DME was observed in 4 eyes: 3 eyes were treatable only with STTA and 1 required additional ICGA-guided laser photocoagulation. Conclusions: ICGA may be useful to detect leaking spots responsible for DME, enabling less invasive focal laser photocoagulation even in some of the eyes with diffuse DME.

Indocyanine green angiography-guided focal navigated laser photocoagulation for diabetic macular edema

2019 ◽  
Vol 63 (3) ◽  
pp. 243-254 ◽  
Author(s):  
Miho Nozaki ◽  
Aki Kato ◽  
Tsutomu Yasukawa ◽  
Katsuya Suzuki ◽  
Munenori Yoshida ◽  
...  
Keyword(s):  
Indocyanine Green ◽  
Macular Edema ◽  
Diabetic Macular Edema ◽  
Laser Photocoagulation ◽  
Indocyanine Green Angiography ◽  
Navigated Laser

scholarly journals Conbercept and Retinal Photocoagulation in the treatment of Diabetic Macular Edema

2019 ◽  
Vol 35 (6) ◽  
Author(s):  
Weizhe Meng ◽  
Ronghua Li ◽  
Xiufen Xie
Keyword(s):  
Macular Edema ◽  
Intravitreal Injection ◽  
Diabetic Macular Edema ◽  
Laser Photocoagulation ◽  
Retinal Nerve Fibre Layer ◽  
Macular Thickness ◽  
Control Group ◽  
Panretinal Photocoagulation ◽  
Observation Group ◽  
Retinal Photocoagulation

Objective: To explore the clinical efficacy of intravitreal injection of conbercept in combination with retinal laser photocoagulation in the treatment of diabetic macular edema. Methods: Ninety patients with diabetic macular edema were selected and grouped into an observation group and a control group using random number table, 45 patients (45 eyes) each group. The control group was given retinal laser photocoagulation, while the observation group was given intravitreal injection of Conbercept on the basis of panretinal photocoagulation. The Best Corrected Visual Acuity (BCVA), thickness of retinal nerve fibre layer (RNFL) and macular thickness were measured through relevant examinations before and after treatment. The intraocular pressures of patients in the two groups were evaluated, and moreover the complications were recorded. Results: The RNFL thickness and macular thickness of the two groups had no statistically significant differences before treatment (P>0.05) and decreased significantly after treatment; the decrease amplitude of the observation group was significantly larger than that of the control group (P<0.05). The BCVA of both groups significantly increased in the 1st, 2nd and 4th week after treatment (P<0.05); the increase amplitude of BCVA of the observation group was more significant than that of the control group at different time points after treatment (P<0.05). The intraocular pressure of the observation group was not significantly different with that of the control group in the 1st, 2nd and 4th week after treatment (P>0.05). There were no severe eye complications and systemic adverse reactions in both groups in the process of follow up. Conclusion: Intravitreal injection of conbercept in combination with retinal laser photocoagulation performs better in improving the BCVA and central macular thickness of patients with diabetic macular edema compared to retinal laser photocoagulation and has high safety. doi: https://doi.org/10.12669/pjms.35.6.512 How to cite this:Meng W, Li R, Xie X. Conbercept and Retinal Photocoagulation in the treatment of Diabetic Macular Edema. Pak J Med Sci. 2019;35(6):1493-1498. doi: https://doi.org10.12669/pjms.35.6.512 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

scholarly journals Infrared reflectance image-guided laser photocoagulation of telangiectatic capillaries in persistent diabetic macular edema

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Hyeon Cheol Roh ◽  
Chaeyeon Lee ◽  
Se Woong Kang ◽  
Kyung Jun Choi ◽  
Jun Soo Eun ◽  
...  
Keyword(s):  
Visual Acuity ◽  
Macular Edema ◽  
Diabetic Macular Edema ◽  
Laser Photocoagulation ◽  
Infrared Reflectance ◽  
Closure Rate ◽  
Image Guided ◽  
Focal Laser Photocoagulation ◽  
Central Subfield Thickness ◽  
Persistent Diabetic Macular Edema

AbstractThis study aimed to assess detection rate of telangiectatic capillaries (TelCaps) with infrared reflectance (IR) and optical coherence tomography (OCT) images and to evaluate the clinical efficacy of IR image-guided focal laser photocoagulation of TelCaps in persistent diabetic macular edema (DME). This retrospective case series included 28 eyes of 28 patients with TelCap and persistent DME refractory to intravitreal anti-vascular endothelial growth factor or corticosteroids. The presence of TelCaps was confirmed using IR and OCT images. All patients were followed up for more than 12 months after direct focal laser photocoagulation of the TelCaps. The TelCap closure rate, changes in best-corrected visual acuity, and central subfield thickness were analyzed. On IR imaging, TelCap appeared as a characteristic hyperreflectivity within a hyporeflective spherical lesion in 85.7% of the eyes. After focal laser photocoagulation, the TelCap closure rate was 57.1% at 3 months and 71.4% at 12 months. A significant improvement in visual acuity and reduction in central subfield thickness were observed at three and 12 months after focal laser photocoagulation (all p < 0.05). The characteristic hyperreflectivity within hyporeflective lesions on the IR image in conjunction with OCT helps identify the TelCap. Our results suggest that IR imaging and OCT-guided focal laser photocoagulation of TelCaps can improve functional and anatomical outcomes in persistent DME.

scholarly journals CHOROIDAL THICKNESS IN PATIENTS WITH DIABETIC MACULAR EDEMA

2021 ◽  
Vol 71 (2) ◽  
pp. 433-37
Author(s):  
Amash Aqil ◽  
Muhammad Moin ◽  
Khadijah Abid ◽  
Ahsan Mehmood
Keyword(s):  
Diabetic Retinopathy ◽  
Macular Edema ◽  
Diabetic Macular Edema ◽  
Choroidal Thickness ◽  
Macular Thickness ◽  
Control Group ◽  
Central Macular Thickness ◽  
Department Of Ophthalmology ◽  
Significant Difference ◽  
The Mean

Objective: To evaluate central macular thickness and choroidal thickness in patients with macular edema due to diabetic retinopathy versus controls. Study Design: Cross-sectional comparative study. Place and Duration of Study: Department of Ophthalmology, Lahore General Hospital, Lahore, from Jan to Jul 2018. Methodology: A retrospective data of 100 eyes from 50 patients having with diabetic macular edema associated with diabetic retinopathy was extracted from hospital registry. Additionally, 100 eyes of 50 individuals without any preexisting ocular conditions, comprising a control group was included in the study. Choroidal thickness measurements were made from the posterior edge of the retinal pigment epithelium to the choroid/sclera junction at subfoveal level using optical coherence tomography. Central macular thickness was also measured for all the enrolled patients. Results: One hundred patients fulfilling the inclusion criteria were enrolled in our study. The mean age was 56.27 ± 14.41 years. The mean Central macular thickness of all the patients were reported as 270.49 ± 72.38 μm, while the choroidal thickness was 284.89 ± 96.51 μm. There was statistically significant difference in central macular thickness between both healthy and diabetic retinopathy with diabetic macular edema groups (p=0.001), whereas insignificant difference existed between the two groups forchoroidal thickness (p=0.735). Conclusion: In patients with diabetic macular edema no significant change in choroidal thickness was observed compared with healthy controls, while the thickness of the retina was high in patients with macular edema due to diabetes.

scholarly journals Outcomes of Intravitreal Bevacizumab in Patients with Diabetic Macular Edema at a Tertiary Hospital in Northern Tanzania

2020 ◽  
pp. 27-34
Author(s):  
Shariza Kanji ◽  
Kazim Dhalla ◽  
William Makupa
Keyword(s):  
Visual Acuity ◽  
Macular Edema ◽  
Diabetic Macular Edema ◽  
Intravitreal Bevacizumab ◽  
Macular Thickness ◽  
Central Macular Thickness ◽  
Central Vision ◽  
Macular Volume ◽  
The Mean ◽  
Anatomical Outcomes

Background: Diabetic macular edema is a type of diabetic maculopathy affecting the central vision, ranging from mild blur to blindness. Laser photocoagulation has been the mainstay of treatment for the past three decades but it has a limited role in improving the central vision. Recent introduction of anti-vascular endothelial growth factors appears to be promising in restoring vision. However, due to its short half life multiple injections are required to control edema and maintain vision. Objectives: To determine the visual and anatomical outcomes of intravitreal bevacizumab in patients with diabetic macular edema. Methods: A hospital based retrospective cross-sectional study was done at Kilimanjaro Christian Medical Center eye department from 2011- 2015. During this time, patients with  diabetic macular edema who were given intravitreal bevacizumab and satisfied the inclusion criteria were included in the study. Visual acuity, central macular thickness and macular volume were recorded at baseline, six, twelve, eighteen, twenty four and thirty weeks respectively. Optical coherence tomography was used to record central macular thickness and macular volume. Univariate and multivariate binary regression analysis were done and the p-value, odds ratio and 95% confidence interval were calculated. Results: The prevalence of Diabetic macular edema was 15.4%. Mean baseline visual acuity improved from  0.9 ± 0.57 log MAR (6/48) to 0.6±0.49 log MAR (6/24) (95% CI 0.207 - 0.389) at 30 weeks. The mean baseline central macular thickness decreased from 426.97 ± 148.358 μm to 280.98 ± 95.89  μm at 30 weeks (95% 151.531 - 187.044, P < .001). The mean baseline macular volume decreased significantly from 10.59 ± 2.55 mm3 to 8.38 ± 1.498 mm3 (95% CI 1.860 - 2.886) at 30 weeks. In multivariate analysis, patients with no hypertension were more likely to have a better visual outcome of 6/18 or better (95% CI 1.064 - 4.420, P < .033). Conclusion: This study shows a high burden of diabetic macular edema in our setting. Intravitreal bevacizumab injection results in better visual and anatomical outcomes.

scholarly journals Characterization of Microaneurysm Closure After Focal Laser Photocoagulation in Diabetic Macular Edema

2013 ◽  
Vol 155 (5) ◽  
pp. 905-912.e2 ◽  
Author(s):  
Su Na Lee ◽  
Jay Chhablani ◽  
Candy K. Chan ◽  
Haiyan Wang ◽  
Giulio Barteselli ◽  
...  
Keyword(s):  
Macular Edema ◽  
Diabetic Macular Edema ◽  
Laser Photocoagulation ◽  
Focal Laser Photocoagulation
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