Focal photocoagulation less invasive for microaneurysms

Focal photocoagulation may be a less invasive method for the treatment of microaneurysms, according to a paper published in the journal Retina.

A team led by Dr Y. Yamada, Department of Ophthalmology and Visual Sciences, Graduate School of Biomedical Sciences, Nagasaki University, Nagasaki, Japan, analysed 13 eyes of diabetic patients who underwent focal photocoagulation for clinically significant macula oedema.

The microaneurysms were evaluated preoperatively, immediately postoperatively and one and two months after photocoagulation with SD-OCT. Fluorescein angiography and colour fundus photography were also used to evaluate the microaneurysms.

Preoperatively, the microaneurysms were circular or elliptical in structure with hyperreflective foci within vessel walls. Immediately after the procedure there were indistinct lesions with hyperreflectivity around the microaneurysms.

Efficient photocoagulations procedures resulted in retinal changes limited to within the inner retina around the microaneurysms and there were no changes in the retinal pigment epithelium. Within two postoperative months the microaneurysms transformed into fine scars and the retinal structure was normalized.

The average retinal foveal thickness increased from 432 ± 70 μm preoperatively to 373 ± 84 μm at the two-month follow-up. SD-OCT is useful for assessing the efficacy of photocoagulations procedures.