Characterization of microaneurysm closure after focal laser photocoagulation in diabetic macular edema.

S. N. Lee, Jay Chhablani, Candy K. Chan, Haiyan Wang, Giulio Barteselli, Sharif El-Emam, Maria L. Gomez, Igor Kozak, Lingyun Cheng, William R. Freeman

Research output: Contribution to journalArticle

Abstract

To characterize microaneurysm closure following focal laser photocoagulation in diabetic macular edema (DME) using simultaneous fluorescein angiography (FA) and spectral-domain optical coherence tomography (SD-OCT). Retrospective observational case series. Leaking microaneurysms (n = 123) were analyzed in eyes (n = 29) with nonproliferative diabetic retinopathy (NPDR) that underwent navigated focal laser photocoagulation in DME and were followed at 3, 6, and 12 months. Closure of diabetic microaneurysms was characterized in detail following focal laser using SD-OCT. Closure rate of microaneurysms by both FA and SD-OCT was 69.9% (84/123), 79.7% (98/123), and 82.9% (102/123) at 3, 6, and 12 months, respectively. Microaneurysm closure rate increased at 6 and 12 months compared to 3 months (P <.003, P <.001). Over half of closed microaneurysms (45/86, 52.3%) left hyperreflective spots while the remaining half (41/86, 47.7%) disappeared without any hyperreflectivity by SD-OCT at 3 months. Hyperreflective spots decreased at 6 (36/99, 36.4%) and 12 months (17/102, 16.7%) with a concomitant increase in complete loss of reflectivity at 6 (63/99, 63.6%) and 12 months (85/102, 83.3%). Smaller outer and inner diameters and heterogeneous lumen reflectivity were positively associated with microaneurysm closure at 12 months (P <.0001, P <.001, P <.03). Characterization of microaneurysms following focal laser photocoagulation resulted in hyperreflective spots and complete resolution of all reflectivity using SD-OCT. Smaller microaneurysms and those with heterogeneous lumen were positively associated with microaneurysm closure. These findings provide greater understanding of localized retinal changes following focal laser photocoagulation in DME treatment.

Original languageEnglish
Pages (from-to)905-912
Number of pages8
JournalAmerican Journal of Ophthalmology
Volume155
Issue number5
Publication statusPublished - May 2013

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Macular Edema
Light Coagulation
Lasers
Optical Coherence Tomography
Fluorescein Angiography
Microaneurysm
Diabetic Retinopathy

ASJC Scopus subject areas

  • Ophthalmology

Cite this

Lee, S. N., Chhablani, J., Chan, C. K., Wang, H., Barteselli, G., El-Emam, S., ... Freeman, W. R. (2013). Characterization of microaneurysm closure after focal laser photocoagulation in diabetic macular edema. American Journal of Ophthalmology, 155(5), 905-912.

Characterization of microaneurysm closure after focal laser photocoagulation in diabetic macular edema. / Lee, S. N.; Chhablani, Jay; Chan, Candy K.; Wang, Haiyan; Barteselli, Giulio; El-Emam, Sharif; Gomez, Maria L.; Kozak, Igor; Cheng, Lingyun; Freeman, William R.

In: American Journal of Ophthalmology, Vol. 155, No. 5, 05.2013, p. 905-912.

Research output: Contribution to journalArticle

Lee, SN, Chhablani, J, Chan, CK, Wang, H, Barteselli, G, El-Emam, S, Gomez, ML, Kozak, I, Cheng, L & Freeman, WR 2013, 'Characterization of microaneurysm closure after focal laser photocoagulation in diabetic macular edema.', American Journal of Ophthalmology, vol. 155, no. 5, pp. 905-912.
Lee SN, Chhablani J, Chan CK, Wang H, Barteselli G, El-Emam S et al. Characterization of microaneurysm closure after focal laser photocoagulation in diabetic macular edema. American Journal of Ophthalmology. 2013 May;155(5):905-912.
Lee, S. N. ; Chhablani, Jay ; Chan, Candy K. ; Wang, Haiyan ; Barteselli, Giulio ; El-Emam, Sharif ; Gomez, Maria L. ; Kozak, Igor ; Cheng, Lingyun ; Freeman, William R. / Characterization of microaneurysm closure after focal laser photocoagulation in diabetic macular edema. In: American Journal of Ophthalmology. 2013 ; Vol. 155, No. 5. pp. 905-912.
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abstract = "To characterize microaneurysm closure following focal laser photocoagulation in diabetic macular edema (DME) using simultaneous fluorescein angiography (FA) and spectral-domain optical coherence tomography (SD-OCT). Retrospective observational case series. Leaking microaneurysms (n = 123) were analyzed in eyes (n = 29) with nonproliferative diabetic retinopathy (NPDR) that underwent navigated focal laser photocoagulation in DME and were followed at 3, 6, and 12 months. Closure of diabetic microaneurysms was characterized in detail following focal laser using SD-OCT. Closure rate of microaneurysms by both FA and SD-OCT was 69.9{\%} (84/123), 79.7{\%} (98/123), and 82.9{\%} (102/123) at 3, 6, and 12 months, respectively. Microaneurysm closure rate increased at 6 and 12 months compared to 3 months (P <.003, P <.001). Over half of closed microaneurysms (45/86, 52.3{\%}) left hyperreflective spots while the remaining half (41/86, 47.7{\%}) disappeared without any hyperreflectivity by SD-OCT at 3 months. Hyperreflective spots decreased at 6 (36/99, 36.4{\%}) and 12 months (17/102, 16.7{\%}) with a concomitant increase in complete loss of reflectivity at 6 (63/99, 63.6{\%}) and 12 months (85/102, 83.3{\%}). Smaller outer and inner diameters and heterogeneous lumen reflectivity were positively associated with microaneurysm closure at 12 months (P <.0001, P <.001, P <.03). Characterization of microaneurysms following focal laser photocoagulation resulted in hyperreflective spots and complete resolution of all reflectivity using SD-OCT. Smaller microaneurysms and those with heterogeneous lumen were positively associated with microaneurysm closure. These findings provide greater understanding of localized retinal changes following focal laser photocoagulation in DME treatment.",
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AU - Barteselli, Giulio

AU - El-Emam, Sharif

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