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Fluorescein angiography versus superimposed OCT-guided macular laser photocoagulation

Session Details

Session Title: Vascular Diseases & Anterior/posterior segment surgery

Session Date/Time: Sunday 29/09/2013 | 11:00-13:00

Paper Time: 11:32

Venue: Hall 3 (Level 0)

First Author: I.Kozak SAUDI ARABIA

Co Author(s):    S. El-Emam   J. Chhablani   S. Rashead   J. Arevalo     

Abstract Details

Purpose:

To compare diabetic macular edema (DME) laser treatment plans using fluorescein angiography (FA) versus optical coherence tomography (OCT) template superimposed on patient’s retinal image. We hypothesize that information from integrated OCT retinal thickness map aligned onto fundus image will have an impact on treatment plan for these patients and that it will be different from FA guided treatment plan.

Setting:

Three tertiary care academic centers.

Methods:

Eighteen eyes of twelve patients with DME undergoing laser photocoagulation with navigated photocoagulator NAVILAS®(OD-OS, Inc., Berlin, Germany) had FA and OCT imaging done before treatment. FA image was acquired with the same instrument and superimposed onto color fundus photo of the same eye. OCT retinal thickness map taken on the Heidelberg Spectralis system was imported to the laser photocoagulator unit and superimposed and aligned onto fundus image of the same magnification off line. The treatment plans for each eye consisted of placing laser spot marks separately on FA and OCT image in a masked fashion. The number of spots placed by physician was compared between FA and OCT templates using matched pairs analysis. The area of dye leakage on FA and increased retinal thickness on OCT on the same eye was measured using Heidelberg Explorer software.

Results:

Three masked retina specialists created treatment plans. The average area of dye leakage on FA was 6.54 mm 2 whereas the average area of increased retinal thickness on OCT superimposed on fundus image of the same eye was 9.82 mm2 (p=0.017). Within those areas of pathology, the average number of planed spots using FA and OCT template was 35.42 and 44.08, respectively (p=0.0023).

Conclusions:

In eyes with DME, the area of retinal thickening appears to be larger on OCT image than the area of dye leakage on FA templates. Physicians have a tendency to place more laser treatment spots when guided by OCT than FA. Integration of OCT map aligned to retina may have an impact on treatment plan once such alignment takes place and such information is available.

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