April 2011
Volume 52, Issue 14
Free
ARVO Annual Meeting Abstract  |   April 2011
Accuracy and Pain of Focal Laser Treatment for Diabetic Macular Edema using a Retinal Navigated Laser (Navilas®)
Author Affiliations & Notes
  • Marcus Kernt
    Department of Ophthalmology, Ludwig-Maximilians-University, Munich, Gruenwald, Germany
  • Raoul Cheuteu
    Department of Ophthalmology, Ludwig-Maximilians-University, Munich, Gruenwald, Germany
  • Florian Seidensticker
    Department of Ophthalmology, Ludwig-Maximilians-University, Munich, Munich, Germany
  • Armin Wolf
    Department of Ophthalmology, Ludwig-Maximilians-University, Munich, Munich, Germany
  • Simeon Dabov
    Department of Ophthalmology, Ludwig-Maximilians-University, Munich, Munich, Germany
  • Christos Haritoglou
    Department of Ophthalmology, Ludwig-Maximilians-University, Munich, Munich, Germany
  • Anselm Kampik
    Department of Ophthalmology, Ludwig-Maximilians-University, Munich, Munich, Germany
  • Michael W. Ulbig
    Department of Ophthalmology, Ludwig-Maximilians-University, Munich, Munich, Germany
  • Aljoscha S. Neubauer
    Department of Ophthalmology, Ludwig-Maximilians-University, Munich, Munich, Germany
  • Footnotes
    Commercial Relationships  Marcus Kernt, Consultant for OD-OS (C); Raoul Cheuteu, None; Florian Seidensticker, None; Armin Wolf, None; Simeon Dabov, None; Christos Haritoglou, None; Anselm Kampik, None; Michael W. Ulbig, None; Aljoscha S. Neubauer, Consultant for OD-OS (C)
  • Footnotes
    Support  None
Investigative Ophthalmology & Visual Science April 2011, Vol.52, 6623. doi:
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      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.

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      © ARVO (1962-2015); The Authors (2016-present)

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Abstract

Purpose: : To investigate accuracy of a navigating laser photo-coagulator in clinically significant macular edema (CSME) and assess treatment pain.

Methods: : 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.

Results: : 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).

Conclusions: : 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.

Keywords: diabetic retinopathy • laser • imaging methods (CT, FA, ICG, MRI, OCT, RTA, SLO, ultrasound) 
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