Macular Circulation Changes Post Transscleral Micropulse Laser Treatment for Glaucoma

Background: Micropulse Transscleral Cyclophotocoagulation (MP-TSCPC) is a new technique that delivers energy laser in pulses to treat POAG. It is minimally invasive and has minimal collateral tissue damage. Its effect on macular microcirculation needs to be explored. Aim: To assess changes on macular circulation following MP-TSCPC laser treatment in POAG patients. Methods: This cross-sectional interventional research study. 30 POAG patients at Suez Canal University Hospital between July 2020 and July 2023. Laser treatment was performed using the CYCLO G6 system. Follow-up assessments were performed two weeks postoperatively. Pre-and post-treatment evaluations included IOP measurement, best-corrected visual acuity (BCVA), and macular vascular metrics (swept-source OCTA). Results: A significant decrease in Mean IOP from 23.27 ± 8.18 mmHg to 14.73 ± 5.6 mmHg. No significant change has been found in BCVA. The FAZ region in superficial and deep layers remained stable. However, macular vascular density significantly decreased in the nasal and inferior sectors. Conclusion: MP-TSCPC effectively reduces IOP and preserve preop. VA. Although the FAZ area remained unchanged, reduced macular vascular density in specific regions suggests a possible localized vascular impact that needs more studies.