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FLUORESCEIN ANGIOGRAPHY VERSUS OPTICAL COHERENCE TOMOGRAPHY-GUIDED PLANNING FOR MACULAR LASER PHOTOCOAGULATION IN DIABETIC MACULAR EDEMA

Kozak, Igor MD, PhD*; El-Emam, Sharif Y. MD; Cheng, Lingyun MD; Bartsch, Dirk-Uwe PhD; Chhablani, Jay MD; Freeman, William R. MD; Arevalo, J. Fernando MD, FACS*,§

Retina:
doi: 10.1097/IAE.0000000000000120
Original Study
Abstract

Purpose: To compare laser photocoagulation plans for diabetic macular edema (DME) using fluorescein angiography (FA) versus optical coherence tomography (OCT) thickness map superimposed on the retina.

Methods: Fourteen eyes with DME undergoing navigated laser photocoagulation with navigated photocoagulator had FA taken using the same instrument. Optical coherence tomography central retinal thickness map was imported to the photocoagulator and with same magnification aligned onto the retina. Three retina specialists placed laser spot marks separately on FA and OCT image in a masked fashion. The spots placed by each physician were compared between FA and OCT and among physicians. The area of dye leakage on FA and increased central retinal thickness on OCT of the same eye were also compared.

Results: The average number of spots using FA and OCT template was 36.64 and 40.61, respectively (P = 0.0201). The average area of dye leakage was 7.45 mm2, whereas the average area of increased central retinal thickness on OCT of the same eye was 10.92 mm2 (P = 0.013).

Conclusion: There is variability in the treatment planning for macular photocoagulation with a tendency to place more spots when guided by OCT than by FA. Integration of OCT map aligned to the retina may have an impact on treatment plan once such information is available.

In Brief

There is variability in the treatment planning for macular laser photocoagulation guided by optical coherence tomography versus fluorescein angiography with a tendency to place more spots when guided by optical coherence tomography than by fluorescein angiography. Integration of optical coherence tomography map aligned to the retina may have an impact on planning once such information is available.

Author Information

*Vitreoretinal Division, King Khaled Eye Specialist Hospital, Riyadh, Saudi Arabia;

Jacobs Retina Center, University of California San Diego, La Jolla, California;

LV Prasad Eye Institute, Hyderabad, India; and

§Retina Division, Wilmer Eye Institute, Johns Hopkins University, Baltimore, Maryland.

Reprint requests: Igor Kozak, MD, PhD, Vitreoretinal Division, King Khaled Eye Specialist Hospital, PO Box 7191, Riyadh 11462, Saudi Arabia; e-mail: ikozak@kkesh.med.sa

I. Kozak, J. Chhablani, and W. R. Freeman are on scientific advisory board of OD-OS, Inc. The authors have no proprietary interest in publishing this article.

None of the authors have any financial/conflicting interests to disclose.

© 2014 by Ophthalmic Communications Society, Inc.