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Long-term evolution of retinal atrophy after focal laser photocoagulation of telangiectatic capillaries: LyoMAC3 study

Eye volume 40, pages 117–122 (2026)Cite this article

Subjects

Abstract

Objective

To assess the evolution of retinal atrophy secondary to focal laser photocoagulation (FLP) for telangiectatic capillaries (TelCaps) in patients with diabetic macular oedema (DMO) or macular oedema secondary to retinal vein occlusion (MERVO).

Methods

A multicentre retrospective study was conducted in DMO or MERVO patients who underwent at least one FLP session for TelCaps followed for 36 months after FLP. The post-FLP horizontal diameter and surface area of atrophic scars were measured by Optical Coherence Tomography (OCT) and on the OCT infrared image, respectively. The degree of atrophy was quantified on the OCT B-scan.

Results

Sixty-nine eyes of 61 patients were included, corresponding to 86 laser scars analysed. The mean scar diameter increased from 315 ± 162 µm at month 1 (M1) to 350 ± 167 µm at M36 (mean increase: 35 µm, p < 0.001). The mean scar area increased from 0.10 ± 0.09 mm2 at M1 to 0.13 ± 0.10 mm2 at M36 (mean increase: 0.03 mm2, p < 0.01) At M1, 2 (2.6%), 74 (96%) and 1 (1.3%) scars were respectively considered “complete Outer Retinal Atrophy” (c-ORA), “incomplete Retinal pigment epithelium and Outer Retinal Atrophy” (i-RORA) and “complete Retinal pigment epithelium and Outer Retinal Atrophy” (c-RORA). At M36, 1 (1.8%), 40 (72.7%) and 14 (25.4%) scars were respectively considered c-ORA, i-RORA and c-RORA.

Conclusion

The size of retinal atrophy secondary to FLP for TelCaps increases significantly over time. Moreover, retinal atrophy undergoes phenotypic changes. Therefore, it seems imperative to respect a laser impact-free perifoveolar safety zone.

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Fig. 1: Multimodal imaging showing c-RORA and i-RORA focal laser spots at 24 months.
Fig. 2: Surface area of laser spots at 1, 6, 12, 24 and 36 months (in mm2) This graph combines a fiddle plot and a box plot.
Fig. 3: Degree of retinal atrophy at 1, 6, 12, 24 and 36 months.

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Data availability

The datasets analysed during the current study are available from the corresponding author on reasonable request.

References

  1. Ciulla TA, Amador AG, Zinman B. Diabetic retinopathy and diabetic macular edema. Diab Care. 2003;26:2653–64. https://doi.org/10.2337/diacare.26.9.2653.

    Article  Google Scholar 

  2. Creuzot-Garcher C, Massin P, Srour M, Baudin F, Dot C, Nghiem-Buffet S, et al. Epidemiology of treated diabetes ocular complications in France 2008-2018-The LANDSCAPE French Nationwide Study. Pharmaceutics. 2022;14:2330. https://doi.org/10.3390/pharmaceutics14112330.

    Article  PubMed  PubMed Central  Google Scholar 

  3. Klein R. The 15-year cumulative incidence of retinal vein occlusion: the beaver dam eye study. Arch Ophthalmol. 2008;126:513. https://doi.org/10.1001/archopht.126.4.513.

    Article  PubMed  Google Scholar 

  4. Darche M, Verschueren A, Castro Farias D, Borella Y, Paques M. Confocal microscopy of telangiectatic capillaries (TelCaps) and other features of microvascular remodeling following branch retinal vein occlusion. J Anat. 2023;243:235–44. https://doi.org/10.1111/joa.13743.

    Article  PubMed  Google Scholar 

  5. Chaperon M, Kodjikian L, Agard E, Mathis T, Billant J, El-Chehab H, et al. Screening of telangiectatic capillaries in chronic macular edema based on multimodal imaging: a study of 101 eyes. LyoMAC1 study. Graefes Arch Clin Exp Ophthalmol. Published online February 16, 2022. https://doi.org/10.1007/s00417-022-05592-y

  6. Preliminary Report on Effects of Photocoagulation Therapy. Am J Ophthalmol. 1976;81:383-96. https://doi.org/10.1016/0002-9394(76)90292-0

  7. Early photocoagulation for diabetic retinopathy. ETDRS report number 9. Early Treatment Diabetic Retinopathy Study Research Group. Ophthalmology. 1991;98:766-85.

  8. Thomley ME, Gross CN, Preda-Naumescu A, Chen KS, Swain T, Mason III JO, et al. Real-World Outcomes in Patients with Branch Retinal Vein Occlusion- (BRVO-) Related Macular Edema Treated with Anti-VEGF Injections Alone versus Anti-VEGF Injections Combined with Focal Laser. Figus M, ed. J Ophthalmol. 2021;2021:1-5. https://doi.org/10.1155/2021/6641008

  9. Paques M, Philippakis E, Bonnet C, Falah S, Ayello-Scheer S, Zwillinger S, et al. Indocyanine-green-guided targeted laser photocoagulation of capillary macroaneurysms in macular oedema: a pilot study. Br J Ophthalmol. 2017;101:170–4. https://doi.org/10.1136/bjophthalmol-2015-308142.

    Article  PubMed  Google Scholar 

  10. Séjournet L, Kodjikian L, Elbany S, Allignet B, Agard E, Chaperon M, et al. Focal photocoagulation as an adjunctive therapy to reduce the burden of intravitreal injections in macula edema patients, the LyoMAC2 study. Pharmaceutics. 2023;15:308. https://doi.org/10.3390/pharmaceutics15020308.

    Article  PubMed  PubMed Central  CAS  Google Scholar 

  11. Ogura S, Yasukawa T, Kato A, Kuwayama S, Hamada S, Hirano Y, et al. Indocyanine green angiography-guided focal laser photocoagulation for diabetic macular edema. Ophthalmologica. 2015;234:139–50. https://doi.org/10.1159/000437360.

    Article  PubMed  CAS  Google Scholar 

  12. Nozaki M, Kato A, Yasukawa T, Suzuki K, Yoshida M, Ogura Y. Indocyanine green angiography-guided focal navigated laser photocoagulation for diabetic macular edema. Jpn J Ophthalmol. 2019;63:243–54. https://doi.org/10.1007/s10384-019-00662-x.

    Article  PubMed  Google Scholar 

  13. Datlinger F, Datlinger A, Pollreisz A, Sacu S, Schmidt-Erfurth U, Datlinger P. Intraprocedural OCT monitoring of the immediate treatment response during indocyanine green angiography-guided laser therapy of teleangiectatic capillaries in diabetic macular edema. Sci Rep. 2022;12:2315. https://doi.org/10.1038/s41598-022-05950-0.

    Article  PubMed  PubMed Central  CAS  Google Scholar 

  14. Maeshima K, Utsugi-Sutoh N, Otani T, Kishi S. Progressive enlargment of scattered photocoagulation scars in diabetic retinopathy. Retina. 2004;24:507–11. https://doi.org/10.1097/00006982-200408000-00002.

    Article  PubMed  Google Scholar 

  15. Shah SS. The evolution of argon laser photocoagulation scars in patients with the ocular histoplasmosis syndrome. Arch Ophthalmol. 1988;106:1533. https://doi.org/10.1001/archopht.1988.01060140701038.

    Article  PubMed  CAS  Google Scholar 

  16. Curcio CA, Sloan KR, Kalina RE, Hendrickson AE. Human photoreceptor topography. J Comp Neurol. 1990;292:497–523. https://doi.org/10.1002/cne.902920402.

    Article  PubMed  CAS  Google Scholar 

  17. Hanhart J, Weill Y, Rozenman Y. In vivo study of the long term structural changes induced by Macular Argon Laser. Curr Eye Res. 2018;43:511–6. https://doi.org/10.1080/02713683.2017.1419572.

    Article  PubMed  Google Scholar 

  18. Dot C, Parier V, Behar-Cohen F, Benezra D, Jonet L, Goldenberg B, et al. Influence of age on retinochoroidal healing processes after argon photocoagulation in C57bl/6j mice. Mol Vis. 2009;15:670–84.

    PubMed  PubMed Central  CAS  Google Scholar 

  19. Sadda SR, Guymer R, Holz FG, Schmitz-Valckenberg S, Curcio CA, Bird AC, et al. Consensus definition for atrophy associated with age-related macular degeneration on OCT. Ophthalmology. 2018;125:537–48. https://doi.org/10.1016/j.ophtha.2017.09.028.

    Article  PubMed  Google Scholar 

  20. Abdelfattah NS, Sadda J, Wang Z, Hu Z, Sadda S. Near-infrared reflectance imaging for quantification of atrophy associated with age-related macular degeneration. Am J Ophthalmol. 2020;212:169–74. https://doi.org/10.1016/j.ajo.2020.01.005.

    Article  PubMed  Google Scholar 

  21. Cole ED, Novais EA, Louzada RN, Moult EM, Lee BK, Witkin AJ, et al. Visualization of changes in the choriocapillaris, choroidal vessels, and retinal morphology after focal laser photocoagulation using OCT angiography. Investig Opthalmol Vis Sci. 2016;57:OCT356 https://doi.org/10.1167/iovs.15-18473.

    Article  Google Scholar 

  22. Kozak I, Oster SF, Cortes MA, Dowell D, Hartmann K, Kim JS, et al. Clinical evaluation and treatment accuracy in diabetic macular edema using navigated laser photocoagulator NAVILAS. Ophthalmology. 2011;118:1119–24. https://doi.org/10.1016/j.ophtha.2010.10.007.

    Article  PubMed  Google Scholar 

  23. Kernt M, Cheuteu RE, Cserhati S, Seidensticker F, Liegl RG, Lang J, et al. Pain and accuracy of focal laser treatment for diabetic macular edema using a retinal navigated laser (Navilas®). Clin Ophthalmol. Published online February 2012;289. https://doi.org/10.2147/OPTH.S27859

  24. Muqit MMK, Gray JCB, Marcellino GR, Henson DB, Young LB, Charles SJ, et al. Fundus autofluorescence and Fourier-domain optical coherence tomography imaging of 10 and 20 millisecond Pascal retinal photocoagulation treatment. Br J Ophthalmol. 2009;93:518–25. https://doi.org/10.1136/bjo.2008.148833.

    Article  PubMed  CAS  Google Scholar 

  25. Higaki M, Nozaki M, Yoshida M, Ogura Y. Less expansion of short-pulse laser scars in panretinal photocoagulation for diabetic retinopathy. J Ophthalmol. 2018;2018:1–8. https://doi.org/10.1155/2018/9371895.

    Article  Google Scholar 

  26. Nagpal M, Marlecha S, Nagpal K. Comparison of laser photocoagulation for diabetic retinopathy using 532-nm standard laser versus multispot pattern scan laser. Retina. 2010;30:452–8. https://doi.org/10.1097/IAE.0b013e3181c70127.

    Article  PubMed  Google Scholar 

  27. Shiraya T, Kato S, Shigeeda T, Yamaguchi T, Kaiya T Comparison of burn size after retinal photocoagulation by conventional and high-power short-duration methods. Acta Ophthalmol (Copenhagen). 2014;92. https://doi.org/10.1111/aos.12393

  28. Luttrull JK. Subthreshold diode micropulse photocoagulation for the treatment of clinically significant diabetic macular oedema. Br J Ophthalmol. 2005;89:74–80. https://doi.org/10.1136/bjo.2004.051540.

    Article  PubMed  PubMed Central  CAS  Google Scholar 

  29. Vujosevic S, Bottega E, Casciano M, Pilotto E, Convento E, Midena E. Microperimetry and fundus autofluorescence in diabetic macular edema: Subthreshold Micropulse Diode Laser Versus Modified Early Treatment Diabetic Retinopathy Study Laser Photocoagulation. Retina. 2010;30:908–16. https://doi.org/10.1097/IAE.0b013e3181c96986.

    Article  PubMed  Google Scholar 

  30. Midena E. Microperimetry. Arch Soc Espanola Oftalmol. 2006;81:183–6.

    CAS  Google Scholar 

  31. Virgili G, Bini A Laser photocoagulation for neovascular age-related macular degeneration. Cochrane Database Syst Rev. 2007;CD004763. https://doi.org/10.1002/14651858.CD004763.pub2

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Author information

Authors and Affiliations

  1. Ophthalmology Department, Hôpital Edouard Herriot, Hospices Civils de Lyon, Lyon, France

    Damien Vingerder, Inès Fenniri, Benjamin Matagrin, Carole Burillon & Corinne Dot

  2. Ophthalmology Department, Hôpital de la Croix-Rousse, Hospices Civils de Lyon, Lyon, France

    Lucas Sejournet, Thibaud Mathis, Philippe Denis & Laurent Kodjikian

  3. Radiotherapy Department, Centre Léon Bérard, Lyon, France

    Benoit Allignet

  4. CREATIS, CNRS UMR 5220, Inserm U1206, INSA-Lyon, Université Jean Monnet Saint-Étienne, Université Claude Bernard Lyon1, Villeurbanne, France

    Benoit Allignet

  5. Ophthalmology Department, Sainte-Anne Military Teaching Hospital (E.A.), Toulon, France

    Emilie Agard

  6. Clinical Research Center, Hôpital de la Croix-Rousse, Hospices Civils de Lyon, Lyon, France

    Thibaud Mathis & Laurent Kodjikian

  7. MATEIS Laboratory, UMR-CNRS 5510, INSA, University Lyon 1, Villeurbanne, France

    Thibaud Mathis & Laurent Kodjikian

  8. Val de Grace French Military Medical Academy, Paris, France

    Corinne Dot

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  1. Damien Vingerder
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Contributions

Conception: DV, LS, CD. Design: DV, LS, CD. Supervision: DV, LS, CD. Materials: DV, LS, EA, IF, BM, CD, TM, CB, PD, LK Data collection and processing: DV, LS, BA Analysis and interpretation: BA, DV Literature review: DV, LS, CD Writer: DV, LS, CD Critical review: DV, LS, EA, IF, BM, BA, CD, CB, TM, PD, LK.

Corresponding author

Correspondence to Corinne Dot.

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Competing interests

CD is a consultant for Abbvie, Bayer, Horus Pharma, Novartis and Roche. L. Kodjikian is a consultant for Allergan/Abbvie, Bayer, Horus, Novartis, Roche and Théa. T. Mathis is a consultant for Allergan/Abbvie, Bayer, GSK, Horus and Novartis. All other authors have no conflicts of interest to declare.

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Vingerder, D., Sejournet, L., Allignet, B. et al. Long-term evolution of retinal atrophy after focal laser photocoagulation of telangiectatic capillaries: LyoMAC3 study. Eye 40, 117–122 (2026). https://doi.org/10.1038/s41433-025-04111-7

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