Diabetic Macular Edema Associated with Peripheral Capillary Nonperfusion

Although not as common as diabetic macular edema associated with macular microaneurysms, there is a syndrome of macular edema secondary to elevated vascular endothelial growth factor produced by areas of capillary nonperfusion in the periphery. In this fluorescein angiogram done with a scanning laser ophthalmoscope the circled area shows capillary nonperfusion. Previous focal laser (indicated by orange arrows) has not been sufficient to stop the leakage (indicated by the blue arrow). Fill-in panretinal laser to the areas of retinal capillary nonperfusion is a rationale next step in treating this patient.