Journal d'ophtalmologie clinique et expérimentale
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Navigated Laser Photocoagulation of Chronic Diabetic Macular Edema

Libor Hejsek, Alexandr Stepanov, Jaroslava Dusová, Jan Studnička, Jan Marák, Jan Beránek, Naďa Jirásková, Pavel Rozsíval and Ján Lešták

Objective: This paper deals with a retrospective evaluation of the effect of navigated photocoagulation of chronic DME with the NAVILAS device.
Methods: The cohort comprised 18 eyes with clinically significant DME. The age range was 41-82 years (median 68) and the monitoring time in all eyes lasted for 12 months. The following examination techniques were employed: best corrected visual acuity (BCVA) tested on ETDRS charts, biomicroscopic examination of the fundus in artificial mydriasis, colour photography, fluorescent angiography (FAG), and optical coherence tomography (OCT, spectral domain Cirrus, C. Zeiss). The values of BCVA and OCT were statistically tested by means of a non-parametric pair test (Wilcoxon). The performed therapy included 1 focal laser treatment of the macula, 9 grid photocoagulations of the macula, and 8 direct photocoagulations of leaking microaneurysms. Laser treatment was done using navigated photocoagulation by NAVILAS device.
Results: The initial BCVA ranged between 0.1 and 0.8 (average 0.5); at the end of the monitoring period the range of BCVA was 0.1 to 1.0 (average 0.5). No statistically significant difference was found between the preoperative and post-operative values of BCVA. The average value of the thickness of the macula in the central field on OCT was 360 μm prior to the intervention and 322 μm at the end of the monitoring time. This difference was statistically significant (p=0.015 Wilcoxon). After laser treatment with a NAVILAS device there was an anatomical improvement in DME. The sight functions (BCVA) remained stabilized.
Conclusion: Navigated photocoagulation of the macula for DME showed in the present cohort of patients a favourable and functional benefit of the used method.