Nozaki Miho, Kato Aki, Yasukawa Tsutomu, Suzuki Katsuya, Yoshida Munenori, Ogura Yuichiro
Department of Ophthalmology and Visual Science, Nagoya City University Graduate School of Medical Sciences, 1-Kawasumi, Mizuho-ku, Nagoya, 467-8601, Japan.
Jpn J Ophthalmol. 2019 May;63(3):243-254. doi: 10.1007/s10384-019-00662-x. Epub 2019 Feb 26.
To evaluate the efficacy of indocyanine-green angiography (ICGA)-guided navigated focal laser photocoagulation for diabetic macular edema (DME).
Prospective, interventional case series.
Six patients (8 eyes) were enrolled in this study. Fluorescein angiography (FA) and ICGA were performed using the Heidelberg Retina Angiogram 2 (Heidelberg Engineering). Navigated focal laser photocoagulation was delivered to the microaneurysms on ICGA using Navilas (OD-OS GmbH, Germany). Central retinal thickness (CRT) and macular volume (MV) were measured by Cirrus HD-OCT (Carl Zeiss Meditec). At 6 months, the best-corrected visual acuity (BCVA), CRT and MV were compared to the values measured on day 0. The distances from the center of fovea to the closest microaneurysms (MAs) were measured on the pre-planned Navilas image.
All eyes had previous treatment history. At 6 months, ICGA-guided navigated focal laser photocoagulation significantly reduced the CRT and the MV (p<0.05), and there was improvement in the BCVA (p<0.05). At 3 months, 5 out of the 8 eyes (63%) underwent additional ICGA-guided navigated focal laser photocoagulation due to remnants of MAs that had been confirmed by ICGA. There was no observed recurrence of edema after the ICGA-guided navigated focal laser photocoagulation during the 6-month follow-up. The mean distance from the center of fovea to the closest MAs was 624.8 ± 377.7 μm (range 336.0-1438.9 μm).
Our data suggest ICGA-guided navigated focal laser photocoagulation may be effective for the treatment of DME.
评估吲哚菁绿血管造影（ICGA）引导下的导航式局灶性激光光凝治疗糖尿病性黄斑水肿（DME）的疗效。
前瞻性、介入性病例系列研究。
本研究纳入6例患者（8只眼）。使用海德堡视网膜血管造影仪2（海德堡工程公司）进行荧光素血管造影（FA）和ICGA检查。使用德国OD-OS GmbH公司的Navilas系统对ICGA上的微动脉瘤进行导航式局灶性激光光凝。采用Cirrus HD-OCT（卡尔蔡司医疗技术公司）测量中心视网膜厚度（CRT）和黄斑体积（MV）。在6个月时，将最佳矫正视力（BCVA）、CRT和MV与第0天测得的值进行比较。在预先规划的Navilas图像上测量从黄斑中心到最近微动脉瘤（MA）的距离。
所有患眼均有既往治疗史。6个月时，ICGA引导下的导航式局灶性激光光凝显著降低了CRT和MV（p<0.05），且BCVA有所改善（p<0.05）。3个月时，8只眼中有5只眼（63%）因ICGA证实的MA残留而接受了额外的ICGA引导下的导航式局灶性激光光凝。在6个月的随访期间，ICGA引导下的导航式局灶性激光光凝后未观察到水肿复发。从黄斑中心到最近MA的平均距离为624.8±377.7μm（范围336.0 - 1438.9μm）。
我们的数据表明，ICGA引导下的导航式局灶性激光光凝可能对DME治疗有效。
