Efficacy of navigated focal laser photocoagulation in diabetic macular edema planned with en face optical coherence tomography versus fluorescein angiography

Int Ophthalmol. 2020 Aug;40(8):1913-1921. doi: 10.1007/s10792-020-01363-y. Epub 2020 Apr 13.

Abstract

Aim: To analyze the efficacy of navigated focal laser photocoagulation (FLP) of microaneurysms in diabetic macular edema (DME) planned using en face optical coherence tomography (OCT) as against fluorescein angiography (FA).

Methods: Twenty-six eyes of 21 DME patients (12 males, 9 females, 69.5 ± 12.3 years) with mean BCVA of 0.52 ± 0.44 LogMAR were included. En face OCT images of deep capillary plexus slab and FA images were used to plan FLP targeting of leaky microaneurysms. The primary outcome measures were central retinal thickness (CRT) and macular volume. The secondary outcome measure was best-corrected visual acuity (BCVA).

Results: The difference in the change of CRT and macular volume between en face OCT and FA-planned FLP after 1 month and at the end of follow-up was not statistically significant (p > 0.05), except for a higher CRT reduction in the en face OCT-planning group (p = 0.007) at the end of mean follow-up of 2.6 ± 0.9 months. There was no difference in BCVA change between the two planning options (p = 0.42).

Conclusion: En face OCT is a non-inferior alternative for FA in the planning of navigated FLP of microaneurysms in DME.

Keywords: Diabetic macular edema; Fluorescein angiography; Focal laser photocoagulation; Microaneurysms; Navigated laser; Optical coherence tomography; Optical coherence tomography angiography.