Evaluation of microaneurysm before and after subthreshold micropulse coagulation for diabetic macular edema using OCT angiography Tatsuhiko Takei 1 , Keiji Inagaki 1 , Kishiko Ohkoshi 1 1Department Ophthalmology, St. Luke's International Hospital pp.831-837
Published Date 2020/7/15
DOI https://doi.org/10.11477/mf.1410213611
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Abstract Purpose:To evaluate the change of retinal microaneurysm after subthreshold micropulse coagulation for diabetic macular edema.

Cases and Method:A retrospective observational study by chart review. Using a micropulse laser(IRIDEX IQ577TM)at St. Luke's International Hospital, a subthreshold laser was applied to the retinal pigment epithelial layer without MA coagulation in diabetic macular edema patients with microaneurysm(MA).MAs were continuously observed by OCTA(ZEISS Cirrus HD-OCT 5000 OCT Angiography)before and one month after the operation. Eyes in which MAs were clearly visualized before and after the operation were included in this study. Using the En face OCTA image and the B-mode Doppler image, the number of MAs before and after the laser and the change in blood flow due to the Doppler findings were evaluated. The primary endpoint was the change in the number of MAs in each retinal layer(the entire retina, superficial, and deep layers)one month after surgery, and the secondary endpoints were the maximum corrected visual acuity before and one month after surgery, foveal retinal thickness(CMT), the change in macular volume.

Results:The results of 11 eyes and 11 eyes(7 males and 4 females, average age 66.7 years)were evaluable. The average number of MAs in the 3×3 mm2 angle of view depicted by OCTA was 7.5, 4.2, 3.4 before treatment and 5.8, 3.5, 2.4 one month after treatment in the entire retina, superficial, and deep layers, respectively. MAs decreased significantly in entire retina and deep layers. Visual acuity(logMAR), CMT(μm), and macular volume(mm3)were 0.12, 343.3, and 11.0 before treatment, and 0.19, 329.2, and 10.6 one month after treatment, respectively.

Conclusion:MAs promptly decreased in one month after subthreshold micropulse coagulation, suggesting that MA decrease is leading to decrease in macular edema.

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