title: Characterization of microaneurysm closure after focal laser photocoagulation in diabetic macular edema.
abstract: OBJECTIVE
  To characterize microaneurysm closure following focal laser photocoagulation in diabetic macular edema (DME) using simultaneous fluorescein angiography (FA) and spectral-domain optical coherence tomography (SD-OCT).
  
  
  METHODS
  Retrospective observational case series.
  
  
  METHODS
  Leaking microaneurysms (n = 123) were analyzed in eyes (n = 29) with nonproliferative diabetic retinopathy (NPDR) that underwent navigated focal laser photocoagulation in DME and were followed at 3, 6, and 12 months. Closure of diabetic microaneurysms was characterized in detail following focal laser using SD-OCT.
  
  
  RESULTS
  Closure rate of microaneurysms by both FA and SD-OCT was 69.9% (84/123), 79.7% (98/123), and 82.9% (102/123) at 3, 6, and 12 months, respectively. Microaneurysm closure rate increased at 6 and 12 months compared to 3 months (P < .003, P < .001). Over half of closed microaneurysms (45/86, 52.3%) left hyperreflective spots while the remaining half (41/86, 47.7%) disappeared without any hyperreflectivity by SD-OCT at 3 months. Hyperreflective spots decreased at 6 (36/99, 36.4%) and 12 months (17/102, 16.7%) with a concomitant increase in complete loss of reflectivity at 6 (63/99, 63.6%) and 12 months (85/102, 83.3%). Smaller outer and inner diameters and heterogeneous lumen reflectivity were positively associated with microaneurysm closure at 12 months (P < .0001, P < .001, P < .03).
  
  
  CONCLUSIONS
  Characterization of microaneurysms following focal laser photocoagulation resulted in hyperreflective spots and complete resolution of all reflectivity using SD-OCT. Smaller microaneurysms and those with heterogeneous lumen were positively associated with microaneurysm closure. These findings provide greater understanding of localized retinal changes following focal laser photocoagulation in DME treatment.
authors: Department of Ophthalmology, Jacobs Retina Center at Shiley Eye Center, University of California San Diego, La Jolla, CA 92037, USA.
authors: Su Na
authors: SN
authors: Lee
authors: Jay
authors: J
authors: Chhablani
authors: Candy K
authors: CK
authors: Chan
authors: Haiyan
authors: H
authors: Wang
authors: Giulio
authors: G
authors: Barteselli
authors: Sharif
authors: S
authors: El-Emam
authors: Maria L
authors: ML
authors: Gomez
authors: Igor
authors: I
authors: Kozak
authors: Lingyun
authors: L
authors: Cheng
authors: William R
authors: WR
authors: Freeman
mesh_terms: D000783:Aneurysm / Q000150:complications / Q000175:diagnosis* / Q000601:surgery; D003930:Diabetic Retinopathy / Q000150:complications / Q000175:diagnosis / Q000601:surgery*; D005260:Female; D005451:Fluorescein Angiography; D005500:Follow-Up Studies; D005654:Fundus Oculi; D006801:Humans; D017075:Laser Coagulation; D008269:Macular Edema / Q000175:diagnosis / Q000209:etiology / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D012160:Retina / Q000473:pathology*; D012161:Retinal Artery; D012189:Retrospective Studies; D041623:Tomography, Optical Coherence; D014792:Visual Acuity
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