Faculty Collaboration Database

Laser therapy versus observation for symptomatic retinal artery macroaneurysms. Graefes Arch Clin Exp Ophthalmol 2015 Apr;253(4):537-41

Date

07/14/2014

Pubmed ID

25016479

DOI

10.1007/s00417-014-2730-3

Scopus ID

2-s2.0-84939888140 (requires institutional sign-in at Scopus site)   15 Citations

Abstract

PURPOSE: The optimal management approach to retinal arterial macroaneurysms (RAM) is unknown. This paper compares long-term outcomes in RAM treated with laser therapy versus observation.

METHODS: This is an IRB-approved retrospective study of patients with symptomatic RAM. Charts of patients with a diagnosis of RAM causing symptomatic visual loss were reviewed. Patients with less than 6 months follow up, other confounding diagnoses, or additional therapy beyond thermal laser were excluded. Statistical analysis was done using χ(2) or Student's t test as appropriate.

RESULTS: Forty-eight patients with RAM were identified and 27 were included in the study (13 treated, 14 observed). Mean visual acuity in the observation group improved from 20/120 to 20/96 (p = 0.53) compared to 20/280 to 20/54 (p = 0.0003) in the treated group. Subgroup analysis showed that visual acuity in primarily hemorrhagic lesions treated with laser therapy improved by 1.21 logMAR compared to a loss of 0.11 logMAR (p = 0.002) in those that were observed. In primarily exudative lesions, both treated and observed lesions showed an improvement of 0.32 logMAR. No patients in the treatment group had a final visual acuity below 20/200 compared to four in the observation group.

CONCLUSION: Treatment with direct laser photocoagulation was associated in this study with greater improvement in visual acuity and may decrease the risk of severe visual loss especially in primarily hemorrhagic RAM lesions. Compared to observation alone.

Author List

Meyer JC, Ahmad BU, Blinder KJ, Shah GK

Author

Baseer Ahmad MD Associate Professor in the Ophthalmology and Visual Sciences department at Medical College of Wisconsin

MESH terms used to index this publication - Major topics in bold

Aged
Aneurysm
Anticoagulants
Argon Plasma Coagulation
Female
Follow-Up Studies
Humans
Male
Observational Studies as Topic
Retinal Artery
Retinal Diseases
Retrospective Studies
Visual Acuity