Premium
Part 4: Laser photocoagulation of macroaneurysms: clinical cases in DME
Author(s) -
Dupas Bénédicte
Publication year - 2019
Publication title -
acta ophthalmologica
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.534
H-Index - 87
eISSN - 1755-3768
pISSN - 1755-375X
DOI - 10.1111/j.1755-3768.2019.8025
Subject(s) - medicine , ophthalmology , retinal , fundus (uterus) , lesion , laser , optics , surgery , physics
Prevalence of capillary telangiectatic capillaries (TelCaps) is estimated to be around 30% of cases in patients with diabetic macular edema (DME). TelCaps may be occult, or barely visible on fundus, because they are frequently associated with haemorrhages, exsudates or because of their transparency. TelCaps can take several appearances: round light red lesion, surrounded by a white ring (corresponding to a thickened wall), or isolated dark red lesions. They can be isolated, or multiple, and are predominant in the macular area. ICG‐angiography allows the detection of the TelCaps, and precise their location compared to larger retinal vessels. Media opacities (such as cataract), or eye movements, or non visualization of TelCaps on fundus, might prevent from efficient photocoagulation. Baseline laser parameters to start with are: spot size 60 µm, spot duration: 50–100 ms, power : 100 mW. Several shots can be performed. If the targeted TelCap is missed, a white burn is visible on the retinal pigmentary epithelium. The TelCaps to close to the fovea (i.e., located <500 µm from the center) should not be treated. We will present several clinical cases to illustrate the photocoagulation technique.