Abstract
Purpose :
Laser photocoagulation remains the gold standard treatment for proliferative diabetic retinopathy (PDR). Navigated Laser (NAVILAS) is a new platform for the application of panretinal photocoagulation (PRP). To date, there have been no published studies examining the outcomes of eyes with persistent PDR switched to NAVILAS for additional PRP.
Methods :
A retrospective review was performed for patients who underwent PRP with the NAVILAS laser from August 1, 2018 to May 1, 2019 at Harbor-UCLA Medical Center. Only patients who underwent additional navigated laser PRP for persistent PDR, and who had at least 6 months follow-up were included in the analysis. Demographic data and treatment parameters including spot count, power, duration, and total energy were recorded. Main outcome measures include post-procedure visual acuity, rates of retreatment, vitreous hemorrhage (VH), tractional retinal detachment (TRD), pars plana vitrectomy (PPV), neovascularization of the iris (NVI), neovascular glaucoma (NVG), and new or worsened macular edema (DME).
Results :
Thirty-seven eyes from 28 patients met inclusion criteria. Average patient age was 52.8 years (range 30-72) and average hemoglobin A1c was 8.1. These eyes had an average of 1.97 (range 1-6) prior PRP treatments, and the majority (>73%) of prior treatments were with the pattern scanning laser (PASCAL).
Prior to PRP, average best corrected visual acuity (BCVA) was 0.47 logMar (20/59 Snellen). Twelve eyes (32%) had prior VH, 3 eyes (8%) had TRD, 17 eyes (46%) had neovascularization of the disc (NVD), and 20 eyes (54%) had DME. PRP for these eyes consisted of 928±728 spots, 339.4±92.6 mW power, 20.6±2.3 ms pulse duration, and 6.3±5.0 J energy applied.
Eyes were followed for 341.2±91.4 days after the procedure. At final visit, average BCVA was 0.45 logMar (20/56 Snellen). During follow-up, 12 eyes (32%) required retreatment, 13 eyes (35%) had new or recurring VH, 1 eye (3%) had TRD, 5 eyes (14%) required PPV, 4 eyes (11%) developed new neovascularization of the iris, and 1 eye (3%) developed new or worsening DME.
Conclusions :
Additional PRP performed with navigated laser (NAVILAS) in patients with persistently active PDR resulted in no significant changes in post-procedure visual acuity. The majority of eyes re-treated with navigated laser PRP achieved clinical regression at nearly one year follow-up.
This is a 2020 ARVO Annual Meeting abstract.