RESEARCH ARTICLE


NAVILAS Laser System Focal Laser Treatment for Diabetic Macular Edema - One Year Results of a Case Series



Jesse J. Jung*, 1, 2, 3, 4, Roberto Gallego-Pinazo11, 2, 5, Antonio Lleó-Pérez6, Jonathan I. Huz1 , Irene A. Barbazetto1, 2, 3, 4
1 Department of Ophthalmology, New York University School of Medicine, New York, NY, USA
2 Vitreous Retina Macular Consultants of New York, New York, NY, USA
3 LuEsther T. Mertz Retinal Research Center, Manhattan Eye, Ear, and Throat Hospital, New York, NY, USA
4 Edward S. Harkness Eye Institute, Columbia University College of Physicians and Surgeons, New York, NY, USA
5 Department of Ophthalmology, University and Polytechnic Hospital La Fe, Valencia, Spain
6 Department of Ophthalmology, Hospital Francesc de Borja, Gandía, Spain


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© Jung et al.; Licensee Bentham Open.

open-access license: This is an open access article licensed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted, non-commercial use, distribution and reproduction in any medium, provided the work is properly cited.

* Address correspondence to this author at the Department of Ophthalmology 462 First Avenue, NBV 5N 18 (Bellevue Hospital Building), New York, NY 10016, USA; Tel: 212-263-6434; Fax: 212-263-8749; E-mail: jung.jesse@gmail.com


Abstract

Purpose:

To report one year outcomes of focal Navigated Retina Laser Therapy (NAVILAS) for diabetic macular edema (DME).

Methods:

Retrospective cohort series of 7 diabetic patients treated with NAVILAS focal laser. Statistical analysis included descriptive and continuous variables (Best-corrected logMAR Visual Acuity and time-domain optical coherence tomography (OCT) parameters) which were compared using a non-parametric procedure, the Friedman tests for repeated measures. A p-value of less than 0.05 was considered to denote statistical significance.

Results:

diabetic patients (4 male; 3 female) with an average age of 60.8 years (range 48-85 years) were included. All treated eyes were phakic; patients had an average hemoglobin A1C of 9.1 (range 7.8-11.7) at baseline and 8.0 (range 7.4-8.4) at 12 months. Six of the 7 patients had intravitreal bevacizumab injections prior to focal laser treatment with 1 patient having had more than 1 prior injection (total 3). At 12 months, median logMAR improved from 0.695 (± interquartile range 0.574) to 0.477 (± 0.573, p <0.001). OCT median central foveal thickness decreased from 248 (± 112) to 220 µm (± 41, p <0.001); total macular volume decreased from 7.84 (± 0.8) to 7.44 mm3 (± 0.7, p = 0.117); and largest macular subfield thickness decreased from 354 (± 116) to 289 µm (± 42, p <0.001). All patients were treated without complications.

Conclusions:

Focal NAVILAS showed to be safe and effective in treating DME with improvement in visual acuity and macular edema on OCT over 12 months in this case series. In clinical practice, combined treatment with focal laser including NAVILAS and anti-vascular endothelial growth factor may provide long-term improvement in DME.

Keywords: : Anti-VEGF, bevacizumab, diabetes, focal laser photocoagulation, macular edema, NAVILAS.