Figure 5

Multimodal imaging of the right eye of a patient with treatment naive diabetic macular edema. Early-phase fluorescein angiography (FA) shows numerous microaneurysms predominantely in the temporal macula (A). Late-phase FA reveals an area of diffuse leakage in this area. In contrast, late-phase indocyanine green angiography (ICGA) (≥ 10 min) reveals one bright hyperreflective spot in and around this area. The OCT thickness map revealed extensive diabetic macular edema involving the fovea (D). Therefore the patient was scheduled for ICGA-guided focal laser therapy. Note that the OCT single scan leads right through the center of the TC, which shows a hyporeflective lumen compared to the surrounding vessel wall (F). Minutes after several laser burst have been applied on the surface on the TC, a darkening of its lumen can be observed with OCT (G). Consequently, the TC fully resolved as early as 4 months after the treatment without damage to the underlying photoreceptors (H, red asterisk), together with most of the intraretinal fluid and only little remaining parafoveal retinal swelling (E).