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Objectives  To compare the efficacy and safety of conventional and navigated laser photocoagulation as the primary treatment option for retinal arteriolar macroaneurysm (RAM).    Methods  Eleven (9 male and 2 females, mean age 65.1 ± 12.1 years) and 17 (13 male and 4 females, mean age 66.2 ± 8.9 years) patients were included in conventional laser photocoagulation (CLP) and navigated laser photocoagulation (NLP) groups, respectively. The primary outcome measures were LogMAR best-corrected visual acuity (BCVA) and central retinal thickness at the end of the follow-up. The secondary outcome measure was total laser energy applied during the procedure.    Results  At the end of the mean follow-up of 11.4 ± 4.0 months, baseline LogMAR BCVA increased significantly from 0.65 ± 0.14 to 0.26 ± 0.12 (p < 0.001) in CLP group and from 0.57 ± 0.33 to 0.29 ± 0.34 (p < 0.001) in NLP group. Central retinal thickness decreased significantly from 514.5 ± 53.2 µm to 295.3 ± 11.3 µm (p < 0.001) and from 494.0 ± 111.2 µm to 285.8 ± 51.4 µm (p < 0.001) in CLP and NLP group, respectively. Total laser energy and number of laser burns applied per procedure in NLP group was statistically significantly lower than in CLP group (0.28 ± 0.13 J vs 0.59 ± 0.06 J, p < 0.001 and 28.5 ± 14.2 burns vs 48.9 ± 5.1 burns, respectively, p < 0.001). No adverse events related to laser treatment was noted in study groups during the follow-up.    Conclusion  This study demonstrated superiority of navigated laser photocoagulation compared to conventional laser photocoagulation in primary treatment of RAM which results from similar efficacy and safety of both techniques with lower mean total laser energy and number of laser burns required for navigated laser photocoagulation.

Direct navigated laser photocoagulation as primary treatment for retinal arterial macroaneurysms