Purchase this article with an account.
Armin R. Afshar, Ravi D. Patel, Rama D. Jager; Combination Therapy With Computer Guided Focal NAVILAS Laser Treatment And Intravitreal Anti-vegf Therapy In The Treatment Of Diabetic Macular Edema. Invest. Ophthalmol. Vis. Sci. 2012;53(14):400.
Download citation file:
© ARVO (1962-2015); The Authors (2016-present)
The purpose of this study was to report a case series of patients treated with the NAVILAS computer-navigated focal laser treatment and intravitreal bevacizumab in the management of diabetic macular edema (DME).
This was a retrospective, non-comparative interventional case series of eyes that underwent combined NAVILAS computer navigated focal laser treatment and intravitreal bevacizumab injections for diabetic macular edema. Patients received intravitreal bevacizumab (1.25 mg/0.05 ml) at baseline and then underwent computer navigated NAVILAS focal laser treatment one week later. Pretreatment NAVILAS planning with typical laser settings of 70 mW power,100 μm size, 70 ms duration resulted in pale, clinically visible lesions. Best-corrected visual acuity and average foveal thickness using spectral domain OCT were measured immediately before laser treatment and at visits up to 6 months.
Over 80 eyes have been treated with NAVILAS as of March 2011 at our institution. Of those, 14 eyes of 12 patients had 6 month follow-up and were reviewed. Mean patient age was 67.4 years. Mean pre-treatment logarithm of the minimum angle of resolution visual acuity (LogMAR VA) was 0.54 (20/70). Mean post-treatment LogMAR VA at 3 months was 0.40 (20/50) with a range of 0.18 - 0.6 (20/30 to 20/80), a statistically significant improvement (p<0.005). Mean macular thickness on Spectralis OCT was 373.4 microns pre-treatment and 320.2 microns at 6 months post-treatment, a statistically significant improvement (p<0.005). The mean number of bevacizumab injections at 6 months was 1.6. No adverse effects were observed in association with either intravitreal injection or with laser treatment.
Intravitreal bevacizumab used in combination with NAVILAS computer guided focal laser treatment appears effective in eyes with diabetic macular edema at 6 months follow-up. While initial studies have shown NAVILAS to be safe and accurate, further studies are warranted to investigate long-term visual outcomes and macular thickness on OCT after treatment.
This PDF is available to Subscribers Only