Abstract
Purpose:
To evaluate the efficacy of NAVILAS® navigated laser treatment in patients with branch retinal vein occlusions (BRVO).
Methods:
Retrospective review of patients treated with NAVILAS® laser at the Rotterdam Eye Hospital for BRVO between October 2011 and November 2013. Follow up data were recorded up to 1 year after treatment. Recorded data were: visual acuity (VA) and central foveal thickness (CFT, OCT RTVue) before and after treatment, number of prior treatments (anti-VEGF, steroid, laser), number of additional treatments after NAVILAS® laser, number of shot and total energy delivered, adverse events.
Results:
In total 44 patients were treated and had a complete dataset for analysis. Twenty-five patients were female. The right eye was involved in 29 patients. Median age was 70 years (range 47 - 93). Median duration of disease prior to NAVILAS® laser was 10 months (range 1 - 60). Median number of anti-VEGF injections prior to NAVILAS® was 3.5 (range 0 - 20, n= 35 out of 44). Eleven patients had received prior steroid injections, 19 patients had prior conservative Argon laser treatment.<br /> Median VA prior to NAVILAS® laser was 0.45 (Snellen, range 0.1 - 1.0). Median CFT prior to NAVILAS® laser was 347 micron (range 235 - 677). Median VA three months after NAVILAS® laser was 0.6 (Snellen, range 0.05 - 1.0). This significant improvement (p < 0.05) was maintained at 1 year. CFT was reduced to a median of 316 micron (range 209 - 702). This statistically significant reduction in CFT further improved up to 1 year (median 310, range 164 - 435, p < 0.05). Patients receiving anti-VEGF injections had overall greater CFT and lower VA at baseline compared to the patients who had no injections prior to NAVILAS® laser.<br /> Median number of shots delivered with NAVILAS®: 69 (range 14-210), median total energy: 0,47J (range 0,08J - 2,82J). Five patients were retreated with NAVILAS® twice, one patient three times. Two patients were retreated with conservative Argon laser. Additional anti-VEGF injections were given in 29 out of 44, median of 1 (range 0-7). Nine patients received additional steroid injection. No adverse events were noted, in particular no complaints of (small) scotoma.
Conclusions:
NAVILAS® navigated laser gives significant improvement in VA and reduction in retinal thickness, even in BRVO patients with extensive prior treatment. NAVILAS® laser appears safe and efficient, and easy to perform and to undergo by the patients.