June 2017
Volume 58, Issue 8
Open Access
ARVO Annual Meeting Abstract  |   June 2017
3-Year-Data of Combined Navigated Laser Photocoagulation (Navilas) and Intravitreal Ranibizumab compared to Ranibizumab Monotherapy in DME patients
Author Affiliations & Notes
  • Julian Langer
    Ophthalmology, Ludwig-Maximilians-University, Munich, Germany
  • Efstathios Vounotrypidis
    Ophthalmology, Ludwig-Maximilians-University, Munich, Germany
  • Marcus Kernt
    Augenarztpraxis Prof. Dr.Kernt, Munich, Germany
  • Siegfried Priglinger
    Ophthalmology, Ludwig-Maximilians-University, Munich, Germany
  • Tina Herold
    Ophthalmology, Ludwig-Maximilians-University, Munich, Germany
  • Footnotes
    Commercial Relationships   Julian Langer, None; Efstathios Vounotrypidis, None; Marcus Kernt, None; Siegfried Priglinger, None; Tina Herold, None
  • Footnotes
    Support  None
Investigative Ophthalmology & Visual Science June 2017, Vol.58, 5982. doi:
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      Julian Langer, Efstathios Vounotrypidis, Marcus Kernt, Siegfried Priglinger, Tina Herold; 3-Year-Data of Combined Navigated Laser Photocoagulation (Navilas) and Intravitreal Ranibizumab compared to Ranibizumab Monotherapy in DME patients. Invest. Ophthalmol. Vis. Sci. 2017;58(8):5982.

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

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Purpose : The prospective CAVNAV study previously showed that a combination of navigated laser photocoagulation (Navilas) and intravitreal injections with ranibizumab achieved similar visual gains at year 1 compared to ranibizumab monotherapy with a significantly reduced number of injections.
The purpose of this study was to determine if the long-term stability of visual gains and lower need of injections in combination therapy patients stated at year 1 could be maintained in a 3 year-follow-up period.

Methods : The charts of CAVNAV patients in both arms remaining under the care of the investigators were subjected to retrospective analysis to determine BCVA at 12, 24 and 36 months and injection count from months 13-36. BCVA measurements following the original 1 year study were taken using logMAR charts. Injections had been provided with standard of care using PRN based on change in BCVA and CRT using Spectral domain OCT scans. Main outcome measures was change in BCVA and mean number of injections from baseline (12 months) to month 36.

Results : BCVA was stable within one line of vision in both groups between from 12 through 36 months, with both cohorts showing a change of 0.16 ± 0.1 logMAR. The lead in BCVA of the cohort with navigated laser of approximately 2 lines was also maintained through month 36.
Following the initial reduction in required injections at month 12, combination therapy patients continued to require 1.4 times fewer injections over the next 24 months (2.91 ± 2.3 vs 4.27 ±3.8 injections for monotherapy).

Conclusions : Combination of navigated laser and ranibizumab achieved BCVA gains comparable to anti-VEGF monotherapy. These results could be maintained through month 36.
Concerning the number of required ranibizumab injections we observed a reduction of 3 injections in year 1 and further 1.4 injections in year 2 and 3 compared to the monotherapy group. Thus, adding navigated laser photocoagulation to intravitreal anti-VEGF therapy may represent a superior therapeutic approach to DME patients with stable functional results and lower injection burden.

This is an abstract that was submitted for the 2017 ARVO Annual Meeting, held in Baltimore, MD, May 7-11, 2017.


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