Purchase this article with an account.
Marcus Kernt, Raoul Cheuteu, Florian Seidensticker, Armin Wolf, Simeon Dabov, Christos Haritoglou, Anselm Kampik, Michael W. Ulbig, Aljoscha S. Neubauer; Accuracy and Pain of Focal Laser Treatment for Diabetic Macular Edema using a Retinal Navigated Laser (Navilas®). Invest. Ophthalmol. Vis. Sci. 2011;52(14):6623.
Download citation file:
© ARVO (1962-2015); The Authors (2016-present)
To investigate accuracy of a navigating laser photo-coagulator in clinically significant macular edema (CSME) and assess treatment pain.
Focal laser for diabetic macular edema (DME) in 36 patients was digitally planned on fundus images and performed with navigation using Navilas® (OD-OS GmbH, Teltow, Germany). Treatment intensity was controlled visually during treatment so the laser spots applied were just barely visible directly after treatment. Using color images (CI) and optical coherence tomography (OCT) we analyzed 4137 laser spots (mean 115 per eye) at one month follow-up and determined accuracy of spot placement. In addition, treatment pain was quantified on a visual analogue scale (VAS) and compared to a matched control group receiving conventional laser treatments.
In total, 79% of laser spots were visible on CI, of which 96% were within 100 µm from the planned target position. On an intention-to-treat (ITT) basis for (CI) 76% of the laser spots were placed and visible within the 100 µm target. OCT confirmed that laser effects were limited to the outer retina, time for focal treatment was mean <7 (+/-3) minutes. Pain on VAS was mean 1.6 (SD 1.0), significantly lower (p<0.001) than for the control group with 4.4 (SD 1.8).
Navigated laser effects could be visualized to high percentage on post-treatment color images, location showed high concordance to preplanning. Documentation of all treatment locations performed - even if they are not visible in CI - can be superpositioned onto the CI. Patient reported pain was significantly lower than with conventional laser treatment.
This PDF is available to Subscribers Only