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Teleophthalmology image-based navigated retinal laser therapy for diabetic macular edema : a concept of retinal telephotocoagulation

Kozak, Igor; Payne, John F.; Schatz, Patrik LU ; Al-Kahtani, Eman and Winkler, Moritz (2017) In Graefe's Archive for Clinical and Experimental Ophthalmology 255(8). p.1509-1513
Abstract

Background: To determine the feasibility and efficacy of a retinal telephotocoagulation treatment plan for diabetic macular edema. Methods: Prospective, interventional cohort study at two clinical sites. Sixteen eyes of ten subjects with diabetic macular edema underwent navigated focal laser photocoagulation using a novel teleretinal treatment plan. Clinic 1 (King Khaled Eye Specialist Hospital, Riyadh, Saudi Arabia) collected retinal images and fundus fluorescein angiogram. Clinic 2 (Palmetto Retina Center, West Columbia, SC, USA) created image-based treatment plans based on which macular laser photocoagulation was performed back at clinic 1. The primary outcome of the study was feasibility of image transfer and performing navigated... (More)

Background: To determine the feasibility and efficacy of a retinal telephotocoagulation treatment plan for diabetic macular edema. Methods: Prospective, interventional cohort study at two clinical sites. Sixteen eyes of ten subjects with diabetic macular edema underwent navigated focal laser photocoagulation using a novel teleretinal treatment plan. Clinic 1 (King Khaled Eye Specialist Hospital, Riyadh, Saudi Arabia) collected retinal images and fundus fluorescein angiogram. Clinic 2 (Palmetto Retina Center, West Columbia, SC, USA) created image-based treatment plans based on which macular laser photocoagulation was performed back at clinic 1. The primary outcome of the study was feasibility of image transfer and performing navigated laser photocoagulation for subjects with diabetic macular edema between two distant clinics. Secondary measures were change in best-corrected visual acuity (BCVA) and central retinal thickness (CRT) by spectral-domain optical coherence tomography at 3 months after treatment. Results: The teleretinal treatment plan was able to be successfully completed in all 16 eyes. The mean logMAR BCVA at baseline was 0.49 ± 0.1, which remained stable (0.45 ± 0.1) 3 months after treatment (p = 0.060). The CRT improved from 290.1 ± 37.6 μm at baseline to 270.8 ± 27.7 μm 3 months after treatment (p = 0.005). All eyes demonstrated improvement in the area of retinal edema after laser photocoagulation, and no eyes demonstrated visual acuity loss 3 months after treatment. Conclusion: This study introduces the concept of retinal telephotocoagulation for diabetic macular edema, and demonstrates the feasibility and safety of using telemedicine to perform navigated retinal laser treatments regardless of geographical distance.

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author
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
Diabetic retinopathy, Macular edema, Navigated retinal photocoagulation, Telemedicine, Teleophthalmology
in
Graefe's Archive for Clinical and Experimental Ophthalmology
volume
255
issue
8
pages
5 pages
publisher
Springer
external identifiers
  • scopus:85018351485
  • wos:000407080300006
ISSN
0721-832X
DOI
10.1007/s00417-017-3674-1
language
English
LU publication?
yes
id
2394bf93-c2f1-4684-84fc-b7289c65e8d4
date added to LUP
2017-05-24 16:34:22
date last changed
2017-09-18 15:20:11
@article{2394bf93-c2f1-4684-84fc-b7289c65e8d4,
  abstract     = {<p>Background: To determine the feasibility and efficacy of a retinal telephotocoagulation treatment plan for diabetic macular edema. Methods: Prospective, interventional cohort study at two clinical sites. Sixteen eyes of ten subjects with diabetic macular edema underwent navigated focal laser photocoagulation using a novel teleretinal treatment plan. Clinic 1 (King Khaled Eye Specialist Hospital, Riyadh, Saudi Arabia) collected retinal images and fundus fluorescein angiogram. Clinic 2 (Palmetto Retina Center, West Columbia, SC, USA) created image-based treatment plans based on which macular laser photocoagulation was performed back at clinic 1. The primary outcome of the study was feasibility of image transfer and performing navigated laser photocoagulation for subjects with diabetic macular edema between two distant clinics. Secondary measures were change in best-corrected visual acuity (BCVA) and central retinal thickness (CRT) by spectral-domain optical coherence tomography at 3 months after treatment. Results: The teleretinal treatment plan was able to be successfully completed in all 16 eyes. The mean logMAR BCVA at baseline was 0.49 ± 0.1, which remained stable (0.45 ± 0.1) 3 months after treatment (p = 0.060). The CRT improved from 290.1 ± 37.6 μm at baseline to 270.8 ± 27.7 μm 3 months after treatment (p = 0.005). All eyes demonstrated improvement in the area of retinal edema after laser photocoagulation, and no eyes demonstrated visual acuity loss 3 months after treatment. Conclusion: This study introduces the concept of retinal telephotocoagulation for diabetic macular edema, and demonstrates the feasibility and safety of using telemedicine to perform navigated retinal laser treatments regardless of geographical distance.</p>},
  author       = {Kozak, Igor and Payne, John F. and Schatz, Patrik and Al-Kahtani, Eman and Winkler, Moritz},
  issn         = {0721-832X},
  keyword      = {Diabetic retinopathy,Macular edema,Navigated retinal photocoagulation,Telemedicine,Teleophthalmology},
  language     = {eng},
  month        = {04},
  number       = {8},
  pages        = {1509--1513},
  publisher    = {Springer},
  series       = {Graefe's Archive for Clinical and Experimental Ophthalmology},
  title        = {Teleophthalmology image-based navigated retinal laser therapy for diabetic macular edema : a concept of retinal telephotocoagulation},
  url          = {http://dx.doi.org/10.1007/s00417-017-3674-1},
  volume       = {255},
  year         = {2017},
}