Retinal Physician

JAN-FEB 2017

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T he OD-OS Inc. (Irvine, CA) Navilas Laser System 577+, a retinal photocoagulator with a digital fundus camera, has long enabled physicians to precisely deliver treatment to preplanned locations in the retina. In December, the FDA approved a com- pact version, the Navilas 577s, designed to extend the benefits of its Laser System 577+ to practices and clinics of all sizes. e Navilas system is indicated for all retinal diseases treated with laser. Studies have shown that the Navilas can be a significant partner in reducing the number of anti-VEGF injections. David M. Brown, MD, clinical profes- sor of ophthalmology at Baylor College of Medicine in Houston, TX, has been using the Navilas technology both in day-to-day clinic operations and as part of a randomized, clinical trial for three years. e system "eliminates human variability for both patients and surgeons," he says. "Analogous to eye-tracked devices used in refractive surgery, the Navilas laser system deliv- ers the prescribed treatment to patients regardless of their eye movements." e technology, he continues, enables physicians to treat pathology that is only visible on fluorescein angiogra- phy (FA), indocyanine green angiogra- phy, or optical coherence tomography (OCT). And it does so, he adds, "in a precise, controlled fashion." Dr. Brown notes that more than 50% of diabetic and retinal vein occlu- sion macroaneurysms (MAs) can only be seen on FA; besides these, the Navilas allows treatment on vis- ible MAs. "Collateral damage that is inevitable with manual lasers doesn't occur, allowing surgeons to aggres- sively target pathologies near the fovea that would be too dangerous to work on otherwise," he says. HOW IT WORKS Navilas uses the OD-OS propri- etary reflex-free fundus imaging sys- tem to acquire high-resolution video and still images of the patient's retina. is can be done using true color or infrared light. e system allows physi- cians to preplan the treatment based on the system's color fundus images or on additional images provided by their own OCT and FA instruments. e system automatically registers these images to the live fundus. e physician can then quickly cre- ate a treatment plan by placing individ- ual spots or grids of any desired shape on these diagnostic images. During the treatment phase, the computer guides the laser to all preplanned locations, recording each successful laser appli- cation. is process lets the physician focus on delivering high-quality treat- ment, while the system stabilizes the laser on the patient's retina, compen- sating for eye movements. As an added benefit, the combination of advanced eye tracking and infrared illumination allows for focal treatments without the use of contact lenses. CLINICAL APPLICATIONS e Navilas system is indicated for use in photocoagulation for the treat- ment of clinically significant diabetic macular edema, proliferative diabetic retinopathy (panretinal photocoagula- tion), subretinal (choroidal) neovascu- larization, central and branch retinal venous occlusion, lattice degeneration, retinal tears, and detachments. It is also indicated for retinal imaging, including color and infrared imaging, and for aid- ing in the diagnosis and treatment of ocular pathology in the posterior seg- ment of the eye. IMPROVING PATIENT OUTCOMES e need for anesthesia is reduced because no contact lens needs to be worn during focal treatments. Both focal and panretinal photoco- N E W P R O D U C T A P P L I C AT I O N S Compact Precision Navilas system delivers treatment to specific locations BY KAREN APPOLD, CONTRIBUTING WRITER R E T I N A L P H Y S I C I A N | J A N U A R Y / F E B R U A R Y 2 0 1 7 66 Unlike conventional, slit-lamp based lasers, no binoculars are needed. In- stead, all relevant information, includ- ing the live view of the patient's retina, are displayed on the screen. During treatment, the physician looks at the screen to observe the patient's retina, see (and steer, if he so chooses) the laser position, and monitor parameters such as laser power. CO U RTESY O F O D - OS

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