Fluorescein angiography versus optical coherence tomography-guided planning for macular laser photocoagulation in diabetic macular edema

Retina. 2014 Aug;34(8):1600-5. doi: 10.1097/IAE.0000000000000120.


Purpose: To compare laser photocoagulation plans for diabetic macular edema (DME) using fluorescein angiography (FA) versus optical coherence tomography (OCT) thickness map superimposed on the retina.

Methods: Fourteen eyes with DME undergoing navigated laser photocoagulation with navigated photocoagulator had FA taken using the same instrument. Optical coherence tomography central retinal thickness map was imported to the photocoagulator and with same magnification aligned onto the retina. Three retina specialists placed laser spot marks separately on FA and OCT image in a masked fashion. The spots placed by each physician were compared between FA and OCT and among physicians. The area of dye leakage on FA and increased central retinal thickness on OCT of the same eye were also compared.

Results: The average number of spots using FA and OCT template was 36.64 and 40.61, respectively (P = 0.0201). The average area of dye leakage was 7.45 mm, whereas the average area of increased central retinal thickness on OCT of the same eye was 10.92 mm (P = 0.013).

Conclusion: There is variability in the treatment planning for macular photocoagulation with a tendency to place more spots when guided by OCT than by FA. Integration of OCT map aligned to the retina may have an impact on treatment plan once such information is available.

Publication types

  • Comparative Study
  • Randomized Controlled Trial

MeSH terms

  • Diabetic Retinopathy / diagnosis
  • Diabetic Retinopathy / physiopathology
  • Diabetic Retinopathy / surgery*
  • Double-Blind Method
  • Female
  • Fluorescein Angiography*
  • Humans
  • Laser Coagulation*
  • Macula Lutea
  • Macular Edema / diagnosis
  • Macular Edema / physiopathology
  • Macular Edema / surgery*
  • Male
  • Middle Aged
  • Prospective Studies
  • Surgery, Computer-Assisted
  • Tomography, Optical Coherence*
  • Visual Acuity / physiology