Treating diabetic macular edema (DME) with anti-VEGF monotherapy has significantly improved visual outcomes in clinical studies. However, in the real world, the injection burden of such a treatment regimen can sometimes lead to poor patient compliance.
One alternative to secure durable outcomes is combining anti-VEGF with navigated laser therapy (i.e. Navilas® 577s Retina Laser, OD-OS GmbH, Teltow, Germany), which optimizes the effect of intravitreal injections by directly decreasing retinal leakage and swelling. As a consequence, the injection burden decreases significantly without compromising therapeutic success.*
A 2019 paper by Menzler et al., compared results from three studies to review the clinical efficacy of Navilas. The authors found that in all studies, Navilas (in addition to anti-VEGF) reduced retinal thickness and improved visual acuity (VA).
“Moreover, the number of anti-VEGF injections is reduced without affecting the physiologic and functional outcome,” noted the authors. “Low-responders to anti-VEGF therapy are expected to benefit from Navilas as a second-line therapy option.”
A New Wave of Visualization and Documentation
The Navilas laser system has been a game changer in the laser management of patients with DME by allowing direct visualization of the fundus and more accurate focal laser photocoagulation of microaneurysms, which is performed based on preplanned treatment locations with the real-time fundus image. The Navilas 577s enables physicians to digitally pre-plan the entire laser therapy on fundus images – as well as on third-party diagnostic images like fluorescein angiography (FA), indocyanine green angiography (ICGA), optical coherence tomography (OCT) or OCT angiography (OCTA) – and to precisely document and execute this therapy plan with the help of computerized image guidance.
Dr. Pradeep Prasad, chief of the ophthalmology division at Harbor-UCLA Medical Center, says: “One of the challenges when applying subthreshold laser is that when you don’t have visual feedback to know where you’ve administered laser. So, with the Navilas documentation, it’s nice, because you can be sure of where you’re applying the laser.”
And now, OD-OS has released a new software update for Navilas 577s: A multimodal export wizard that retina specialists can use to flexibly generate high resolution images of their focal and peripheral treatments in different configurations. This allows for advanced, transparent documentation for all purposes and records. Furthermore, it facilitates knowledge sharing in different scenarios – with colleagues in talks and in publications, with residents and students for teaching purposes, and with patients for education on the treatments performed.
“The Navilas 577s system was also designed with teaching the next generation of laser surgeons in mind,” said Dr. Winfried Teiwes, managing director at OD-OS. “Thanks to the digital pre-planning functionality, supervisors can review laser plans of their residents prior to treatment and monitor treatments on a computer screen in real-time. Now the multimodal export function adds to its real-time teaching capabilities so that supervisors can more easily perform post-treatment evaluations and share knowledge in teaching scenarios and academic lectures.”
Source: OD-OS Press release, Available at https://www.od-os.com/latest-news/detail/asrs-2019-multimodal-reporting-made-easy-with-the-navilas-577s-retina-laser/
* Menzler J, Neubauer A, Ziemssen F. Navigated laser in diabetic macular edema: the impact of reduced injection burden on patients and physicians-who wins and who loses? Int J Ophthalmol. 2019; 12(2): 342–345.
Editor’s Note: To learn more, watch this video: https://www.od-os.com/navilas-laser-systemr/multimodal-reports/.
