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Review
. 2014 Feb;10(1):66-69.
doi: 10.17925/EE.2014.10.01.66. Epub 2014 Feb 28.

Navigated Laser Therapy for Diabetic Macular Oedema

Affiliations
Review

Navigated Laser Therapy for Diabetic Macular Oedema

Marcus Kernt et al. Eur Endocrinol. 2014 Feb.

Abstract

Navigated laser therapy introduces computerised assistance systems to retinal laser photocoagulation treatment. Some of the main benefits the Navilas system offers over conventional laser include high precision and safety and provides additional advantages in terms of standardisation of planning, execution, documentation, quality assurance and better overall treatment comfort for the patient. Navigated laser therapy is being used with good success in the treatment of diabetic macular oedema (DMO), retinal vein occlusions (RVO) and fastpattern navigated panretinal photocoagulation in proliferative diabetic retinopathy (PDR). In centre-involving DMO, a combination of anti-vascular endothelial growth factor (VEGF) and macular laser may provide advantages over anti-VEGF monotherapy. In terms of navigated laser therapy, recent study data from our clinic and other institutions indicate that combined initial anti-VEGF and navigated macular laser therapy allows treatment success to be achieved and maintained with a significantly reduced number of interventions.

Keywords: Diabetic retinopathy; ETDRS; diabetes; macular oedema; navigated laser therapy; pattern laser.

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Conflict of interest statement

Disclosure: Marcus Kernt and Aljoscha S Neubauer are scientific consultants to OD-OS GmbH. The remaining authors have no conflicts of interest to declare.

Figures

Figure 1:
Figure 1:. Treatment Plan for Navigated Laser
The treatment plan has been prepared based on an imported external optical coherence tomography thickness map. Here, a suitable grid pattern is placed onto the site of oedema. For reference, the Navilas colour image is displayed in a separate window.
Figure 2:
Figure 2:. Treatment with Plan Overlaid Onto Live Retina
The pre-defined treatment plan with single spots and/or grid patterns is superimposed on the live retinal image (here: colour; alternative: infrared) and the aiming beam stabilised in real-time for an accurate and complete treatment.
Figure 3:
Figure 3:. Navigated Panretinal Laser
In navigated panretinal laser, patterns are placed on the live retina as viewed in colour or infrared and the aiming beam is stabilised on location. Previously applied spots are marked as blue circles to avoid duplicate application and to allow for subvisible burns.
Figure 4:
Figure 4:. Elements of Retina Navigation
The focal treatment workflow includes the steps: Image, Plan, Treat, Document.

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