Name

Evaluation du traitement par laser focal des macroanévrismes capillaires dans l'œdème maculaire diabétique et l'œdème maculaire associé aux occlusions veineuses rétiniennes: Etude LyoMAC2

To assess the efficiency of focal laser photocoagulation of capillary macroaneurysms (CMA) in patients with longstanding macular edema (ME).

Retrospective multicentric study of patients followed for diabetic macular edema or ME secondary to retinal vein occlusion (MERVO). Capillary macroaneurysms, identified by indocyanine green angiography and/or optical coherence tomography, and involved in ME were selectively photocoagulated.  The patients were followed within one year after photocoagulation and were assessed according to their intravitreal injections (IVI). 

93 eyes from 76 patients were included in this study. All patients had been treated for at least one year before inclusion with intravitreal injections. Mean duration of ME was 23.9 months. Baseline median best corrected visual acuity (BCVA) was 0.32 logMAR. Mean number of capillary macroaneurysms (CMA) per eye was 2.57 (range 1-7) and their mean size was 172 µm (range 100-404). Mean number of IVI within the 12 months prior to inclusion was 4.44.

At 6 months (n=93/93), there was a significant reduction in macular thickness (mean 353.8 vs 313.6, p<0.001), a decrease of the number of IVI (mean 2.52 vs 1.54, p<0.001). BCVA remained stable (0.32 vs 0.31, p = 0.95).

At 12 months (n=63/93), there was a significant decrease of the number of IVI (mean 4.44 vs 2.72, p<0.001), in macular thickness (mean 353.8 vs 289, p<0.001), while BCVA remained stable (mean 0.32 vs 0.28, p= 0.20).

Focal laser photocoagulation of capillary macroaneurysms could be an adjuvant therapy in addition to intravitreal injections (IVI), allowing to decrease or discontinue the number of IVI in patients with diabetic macular edema or macular edema secondary to retinal vein occlusion.

Focal laser photocoagulation of capillary macroaneurysms seems to be effective and safe in patients with longstanding ME secondary to diabetes and RVO.