**18. Early start in eyes with perimacular edema**

Recent or chronic edema close to the macula seldom affects the visual acuity, however it tends to progress centrally after major non-ocular surgeries, severe infections

and exacerbations of cardiovascular and renal complications (**Figures 3**, **4** and **7**). Early intravitreal treatment is usually effective and results in high visual acuity – in our cohort, 40% of the eyes with final BCVA 20/40 and better had significant perimacular edema at baseline. In eyes with more distant chronic lesions where persistent leakage and hypoperfusion are evident, intravitreal treatment can be followed by delicate focal laser once the edema has regressed. The classical perivascular technique of P. Hamilton performed with the 50 micrometer spot and minimal power settings applied in the temporal half of the posterior pole is suitable in severe chronic cases.
