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francesca amoroso, Alexandre PEDINIELLI, Polina Astroz, Alexandra Miere, ALEXANDRA MOUALLEM-BEZIERE, Oudy Semoun, Mayer Srour, Eric H Souied; OCTA-guided navigated laser therapy for diabetic macular oedema. Invest. Ophthalmol. Vis. Sci. 2019;60(9):3680. doi: https://doi.org/.
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© ARVO (1962-2015); The Authors (2016-present)
To evaluate the accuracy of the navigated laser photocoagulation system (NAVILAS®, OD-OS GmBH, Teltwo, Germany) based on Optical coherence tomography angiography (PlexElite 9000, Carl Zeiss Meditec, Inc., Dublin, USA) for the treatement of microaneurysms (MAs) secondary to diabetic macular oedema (DME).
This prospective case-series included ten eyes of ten consecutive patients presenting with focal diabetic macular oedema. All patients were treated with Navilas® using overlaid OCTA images of visible MAs. Inclusion criteria consisted in non proliferative diabetic retinopathy complicated by focal diabetic macular oedema in which the MAs are visible on OCTA scans (deep capillary plexus, superficial capillary plexus or both), with a maximal macular thickness(macular thickness in the region of focal oedema) ≤450micron. Exclusion criteria included prior macular laser grid, previous anti-VEGF in the last three months or corticosteroid intravitreal injections in the last six months, pathologic myopia (axial lenght >26mm) and any previous vitreoretinal surgery. All patients underwent a complete ophthalmic examination in addition to visual acuity assessment, autofluorescence, spectral domain optical coherence tomography, fluorescein angiography, indocyanine green angiography and optical coherence tomography angiography were done at baseline 1 and 3 months after treatment. During the three months follow-up the patients did not beneficiate of any further treatement (anti-VEGF, corticosteroid intravitreal injections) in order to evaluate the laser response.
Among OCTA findings, the treated MAs were localized in the DCP or both DCP and SCP. Of 52 MAs visible on OCTA, 48 (96%) were occluded by Navilas with flow disappearance just after the laser treatement. The occlusion persisted at 1 and 3 months.Maximal macular thicknesswas significantly reduced in 9 of the 10 eyes treated (p<0.001) with a visual acuity improvement or stabilisation in all eyes.
This preliminary study showed that Navilas® treatment based on manually imported OCTA images seems to be accurate and effective for the treatement of MAs secondary to DME. A bigger sample size and a longer follow-up is needed to confirm the efficacy and the long-term safety of this treatment.
This abstract was presented at the 2019 ARVO Annual Meeting, held in Vancouver, Canada, April 28 - May 2, 2019.
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