Abstract
Purpose: :
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.
Methods: :
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.
Results: :
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.
Conclusions: :
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.
Keywords: diabetic retinopathy • edema • laser