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Robert J. Lowe, Jasmine H. Francis, Patricia Garcia, Joseph Panarelli, Richard B. Rosen; Clinical and Optical Coherence Tomography Findings in Patients Undergoing Focal Laser Treatment with the Navilas Laser System. Invest. Ophthalmol. Vis. Sci. 2011;52(14):1301.
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To review the clinical and optical coherence tomography (OCT) findings in diabetic patients with clinically significant macular edema (CSME) or diabetic macula edema (DME), whom received a single episode of focal laser treatment with the Navilas laser (OD-OS GmbH, Teltow, Germany). The Navilas laser is equipped with a unique retinal navigation system, developed to improve safety and to be more predictable.
Our study was an interventional retrospective case series. All eyes underwent complete ophthalmic examination and OCT before and after receiving a single episode of focal laser treatment with the Navilas laser system.
Nine eyes of 9 diabetic patients (4 men, 5 women) with CSME or DME were included. Average age was 55 years (range: 27 to 63 years). Pre-laser mean visual acuity (Va) was logMAR 0.49 ± 0.36, Snellen equivalent of 20/62 (range: 20/25 to 20/400). All patients tolerated the procedure well. Five required further focal laser treatment. One later needed panretinal photocoagulation, and 2 received intravitreal bevacizumab. One patient required no further treatment. At 3 months post-laser, most patients had improvements in Va, with a statistically significant improved mean logMAR Va of 0.40 ± 0.39; p ≤ 0.03 (Snellen equivalent 20/50) compared to baseline. However, no statistically significant difference between the mean logMAR Va at 6 months and baseline was found. Post-laser OCTs at 3 months revealed increases in mean perifoveal thicknesses superiorly, temporally, and centrally, but these were not statistically significant. At 3 months patients had statistically significant reductions in perifoveal thicknesses inferiorly (p ≤ 0.04) and nasally (p ≤ 0.005). All perifoveal areas demonstrated non-statistically significant decreased thicknesses at 6 months post-laser.
The Navilas laser was a well-tolerated focal laser alternative with a unique retinal navigation system. At 3 months post-laser, patients had a mild but statistically significant improvement in Va. This was in addition to statistically significant reductions in the perifoveal inferior and nasal thicknesses at 3 months post-laser. Gains in Va and reductions in perifoveal thicknesses were not found 6 months post-laser. In our study, one episode of laser treatment with the Navilas seemed to help improve vision in the intermediate term and stabilize vision more long term.
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