Telangiectatic capillaries causing persistent diabetic macular edema successfully treated by photodynamic therapy

Retin Cases Brief Rep. 2023 Jun 19. doi: 10.1097/ICB.0000000000001446. Online ahead of print.

Abstract

Purpose: To report two cases of persistent macular edema caused by the exudation of diabetic telangiectatic capillaries (TelCaps) which have been successfully treated with photodynamic therapy (PDT).

Methods: review of data from two patients suffering from persistent macular edema caused by parafoveolar TelCaps. In both cases, conventional laser was impossible, because TelCaps were to close from foveal center.

Results: The use of focal PDT on perifoveolar TelCaps permitted to reduce persistent macular edema and to avoid inefficient intra-vitreal anti-vascular epithelial growth factor (anti-VEGF) or steroid injections. In both cases, visual acuity was fully restored four to six months after PDT. Central Macular Thickness was also normalized in the first case and significantly reduced in the second case. In both cases, visual gain was sustained throughout the whole follow-up period (2 and 1 year respectively).

Conclusion: PDT can be helpful to treat diabetic macular edema caused by TelCaps non-responding to approved intravitreal therapy or for which conventional laser is contraindicated.