Indocyanine-green-guided targeted laser photocoagulation of capillary macroaneurysms in macular oedema: a pilot study

Pâques, Michel; Philippakis, Elise; Bonnet, Clémence; Falah, Sabrina; Ayello-Scheer, Sarah; Zwillinger, Stéphanie; Girmens, Jean-François; Dupas, B.

doi:10.1136/bjophthalmol-2015-308142

Cited by 35 publications

(70 citation statements)

References 31 publications

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“…Moreover, leaky MAs were well detected on ICGA because of less dye leakage (Fig. 1i, j) [11, 12]. Fresh MAs were sometimes not detected on ICGA, although the reason was not clear.…”

Section: Methodsmentioning

confidence: 99%

Structural and Functional Analyses of Retinal Ischemia in Eyes with Retinal Vein Occlusion: Relationship with Macular Edema or Microaneurysm Formation

et al. 2018

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Purpose: To study the structural and functional changes of retinal ischemia and investigate their association with macular edema (ME) or microaneurysm (MA) formation in eyes with retinal vein occlusion (RVO). Methods: Sixty eyes of 30 patients (27 eyes with branch [b]RVO, 3 with central RVO, and 30 fellow eyes) were retrospectively reviewed. Optical coherence tomography (OCT), OCT angiography (OCTA), and microperimetry were performed simultaneously to measure retinal thickness and sensitivity. The presence of ME or MA was also assessed using OCT and fluorescein angiography. Results: The mean retinal sensitivity in the nonperfused areas (NPAs) deteriorated, and this was significantly (r = –0.379, p = 0.0391*) and inversely correlated with duration from disease onset. ME and MA were unlikely to be observed around the area where the retinal sensitivity decreased. In the NPAs, the mean retinal thickness of the superficial capillary plexus (SCP) (p < 0.0001), deep capillary plexus (DCP) (p = 0.0323), and outer retina (p = 0.0008) were significantly thinner than those in the fellow eyes, respectively. Multivariate regression analysis revealed that the thicknesses of the DCP (β: 0.3107, p = 0.0007) and outer retina (β: 0.3482, p = 0.0001) were the independent correlative factors of the retinal sensitivity, but that SCP thickness was not. Conclusion: Deep retinal thinning in NPAs was correlated significantly with a decreased retinal sensitivity, which might be a negative predictor of ME and MA in eyes with RVO.

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“…Moreover, leaky MAs were well detected on ICGA because of less dye leakage (Fig. 1i, j) [11, 12]. Fresh MAs were sometimes not detected on ICGA, although the reason was not clear.…”

Section: Methodsmentioning

confidence: 99%

Structural and Functional Analyses of Retinal Ischemia in Eyes with Retinal Vein Occlusion: Relationship with Macular Edema or Microaneurysm Formation

et al. 2018

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“…algorithms [11][12][13] . Undesirable adverse events like nausea and emesis or even rare but serious anaphylaxis are addressed to the use of intravenous dye.…”

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confidence: 99%

Detection rate of diabetic macular microaneurysms comparing dye-based angiography and optical coherence tomography angiography

Stattin

Haas

Ahmed

et al. 2020

Sci Rep

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Diabetic maculopathy (DM) is a microvascular dysfunction clinically characterized by microaneurysms (MA) leading to edema and central visual deprivation. This prospective explorative study investigated 27 eyes of 17 patients with DM by fluorescein/indocyanine green angiography (FA/ICGA; SPECTRALIS HRA-OCT, Heidelberg Engineering) and by swept source-optical coherence tomography angiography (SS-OCTA; DRI-OCT Triton Plus, Topcon) to identify clinically relevant MAs. The SS-OCTA cubes were split into the superficial capillary plexus (SCP) and the deep capillary plexus (DCP) according to the automated segmentation. The images of all modalities were superimposed for alignment by an Early Treatment Diabetic Retinopathy Study grid overlay and compared to each other. In total, the mean number of MAs in FA was 33.4 ± 22 (standard deviation) (median 27.5 [q1:21.75;q3:38.25]), in ICGA 24.9 ± 16.9 (17.5 [14;35]), in the SCP 6.5 ± 3.7 (5.5 [3.75;9.25]) and in the DCP 18.1 ± 10.5 (18.5 [10.75;23.5]). Mixed effects models between ICGA and the DCP were borderline significant (p = 0.048; 95% confidence interval 0.21 to 13.49), whereas all other imaging methods differed significantly. Quantitative analysis of MAs in DM showed a plausible agreement between ICGA and the DCP in SS-OCTA. These findings contribute to the imaging methodology in DM.

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“…Therefore, the dye hardly leaks, ICGA defines the detailed retinal vascular abnormalities better than FA [ 21 – 24 ]. Previously, we have reported that middle- to late-phase ICGA images show responsible MAs adjacent retinal edema, resulting in more precise and less number of focal laser photocoagulation spots [ 25 , 26 ], and other groups also reported the clinical efficacy of ICGA-guided laser [ 27 , 28 ]. However, it is difficult to identify the location of MAs on ICGA, due to lack of information of foveal avascular zone.…”

Section: Discussionmentioning

confidence: 99%

Evaluation of Navigated Laser Photocoagulation (Navilas 577+) for the Treatment of Refractory Diabetic Macular Edema

Kato

Nozaki

Kato

et al. 2018

Journal of Ophthalmology

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Purpose To evaluate navigated laser photocoagulation for the treatment of refractory diabetic macular edema (DME). Methods Retrospective study of 25 eyes (21 patients) treated with Navilas 577+ focal laser system. Best-corrected visual acuity (BCVA) and spectral-domain optical coherence tomography (OCT) parameters were measured at baseline, 1, 3, and 6 months, and final visit. Results The mean follow-up period was 12.8 ± 2.4 (7–16 months). All subjects had history of previous treatment which was injection of triamcinolone acetonide or antivascular endothelial growth factor (VEGF) agents. The navigated laser photocoagulation was delivered to the microaneurysms on indocyanine green angiography (ICGA) in 21 of 25 eyes (84%), fluorescein angiography (FA) guided in 3 eyes, and OCT angiography guided in 1 eye. After initial navigated laser treatment, 16 of 25 eyes (64%) were needed additional navigated laser photocoagulation, injection of triamcinolone acetonide, and/or injection of VEGF agents. Although median BCVA remained stable, the central retinal thickness and macular volume were significantly decreased over 6 months (p < 0.05). All patients were treated without complications. Conclusions Focal photocoagulation using Navilas 577+ showed to be effective in treating DME with improvement in macular edema on OCT over 6 months. Navilas 577+ was beneficial to perform navigated laser photocoagulation based on three modalities (ICGA, FA, and OCT angiography).

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Indocyanine-green-guided targeted laser photocoagulation of capillary macroaneurysms in macular oedema: a pilot study

Cited by 35 publications

References 31 publications

Structural and Functional Analyses of Retinal Ischemia in Eyes with Retinal Vein Occlusion: Relationship with Macular Edema or Microaneurysm Formation

Structural and Functional Analyses of Retinal Ischemia in Eyes with Retinal Vein Occlusion: Relationship with Macular Edema or Microaneurysm Formation

Detection rate of diabetic macular microaneurysms comparing dye-based angiography and optical coherence tomography angiography

Evaluation of Navigated Laser Photocoagulation (Navilas 577+) for the Treatment of Refractory Diabetic Macular Edema

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