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Ophthalmic Images
December 14, 2017

Arcuate Retinal Nerve Fiber Layer Defect After Laser Photocoagulation for Diabetic Macular Edema

Author Affiliations
  • 1Department of Ophthalmology, Duke University, Durham, North Carolina
  • 2Asheville Veterans Affairs Medical Center, Asheville, North Carolina
JAMA Ophthalmol. 2017;135(12):e174877. doi:10.1001/jamaophthalmol.2017.4877

An individual aged mid-50s with diabetes had visual acuity of 20/25 OS. Optical coherence tomography revealed an aneurysmal dilation with associated retinal edema (central subfield thickness, 288 μm) and congenital vessel tortuosity (unrelated to the edema). Laser photocoagulation was applied directly to the aneurysm using a 577-nm yellow laser (power, 100 mW; duration, 0.1 milliseconds; spot size, 100 μm) (Figure). Two months later, infrared imaging revealed an asymptomatic, arcuate defect of the retinal nerve fiber layer. At 18 months, visual acuity was 20/20 (central subfield thickness, 278 μm), and the arcuate defect no longer was apparent.