Igor Kozak1,2, John F Payne3, Patrik Schatz4,5, Eman Al-Kahtani4, Moritz Winkler6. 1. Vitreoretinal Division, King Khaled Eye Specialist Hospital, Riyadh, Saudi Arabia. igor.kozak@moorfields.ae. 2. Moorfields Eye Hospital Centre, Marina Village, Abu Dhabi, United Arab Emirates. igor.kozak@moorfields.ae. 3. Palmetto Retina Center, West Columbia, SC, USA. 4. Vitreoretinal Division, King Khaled Eye Specialist Hospital, Riyadh, Saudi Arabia. 5. Department of Ophthalmology/Clinical Sciences, Skane University Hospital, Lund, Sweden. 6. OD-OS, GmbH, Teltow, Germany.
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 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.
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.
Authors: Paolo S Silva; Jerry D Cavallerano; Ann M Tolson; Jessica Rodriguez; Sashida Rodriguez; Radwan Ajlan; Dorothy Tolls; Bina Patel; Mina Sehizadeh; Komal Thakore; Jennifer K Sun; Lloyd Paul Aiello Journal: Diabetes Care Date: 2015-06-01 Impact factor: 19.112
Authors: O Bennett Walton; Robert B Garoon; Christina Y Weng; Jacob Gross; Alex K Young; Kathryn A Camero; Haoxing Jin; Petros E Carvounis; Robert E Coffee; Yvonne I Chu Journal: JAMA Ophthalmol Date: 2016-02 Impact factor: 7.389
Authors: April Y Maa; Centrael Evans; William R DeLaune; Purnima S Patel; Mary G Lynch Journal: Telemed J E Health Date: 2014-02-14 Impact factor: 3.536
Authors: Paolo S Silva; Mark B Horton; Dawn Clary; Drew G Lewis; Jennifer K Sun; Jerry D Cavallerano; Lloyd Paul Aiello Journal: Ophthalmology Date: 2016-03-02 Impact factor: 12.079
Authors: Graham E Quinn; Anna Ells; Antonio Capone; G Baker Hubbard; Ebenezer Daniel; P Lloyd Hildebrand; Gui-Shuang Ying Journal: JAMA Ophthalmol Date: 2016-11-01 Impact factor: 7.389
Authors: Aljoscha S Neubauer; Julian Langer; Raffael Liegl; Christos Haritoglou; Armin Wolf; Igor Kozak; Florian Seidensticker; Michael Ulbig; William R Freeman; Anselm Kampik; Marcus Kernt Journal: Clin Ophthalmol Date: 2013-01-16