Diabetic retinopathy and retinal vein occlusion represent two prevalent vision-threatening retinal diseases. Retinal laser therapy still plays an important role in treating these conditions, but its successful administration often requires referral to specialized centers and retina experts. It is, therefore, essential to develop a new treatment methodology that enables patients to benefit from the expertise of specialists from reference centers. For this purpose, we investigated the feasibility of teleguided photocoagulation conducted across continents to determine if different ophthalmologists can consensually devise and safely execute treatment plans remotely. Two patients from Italy (Europe) with diabetic retinopathy and one from Arizona (USA) with central retinal vein occlusion underwent retinal photocoagulation using Navilas® 577s with remote teleguidance from the corresponding continental counterpart. The process included remote planning and execution, supported by an audio connection for real-time communication. Teletreatment success criteria included treatment plan completion, patient tolerance, remote connection stability, and technical quality. All treatments have been successfully performed with accurate spot application and no technical issues. Follow-ups at three weeks confirmed positive outcomes for each patient. Remote teleguided retinal photocoagulation appears feasible, offering a promising tool for global collaborations in retina care and potential benefits to regions with limited access to expert supervision.
Keywords: diabetic retinopathy; navigated retinal laser; retinal vein occlusion; telemedicine; teleophthalmology; teletreatment.
Plain language summary Remote-planned laser treatment for retinal diseases, connecting patients and eye-specialists worldwide - Diabetic retinopathy and retinal vein occlusion are two of the most common vision-threatening eye diseases, affecting over 190 million people globally. Retinal laser photocoagulation is a well-established treatment, but referral Centres and retina specialists are often necessary. For this reason, a new treatment methodology was needed to reach patients even in the most remote places, offering them the possibility of having the best possible treatment. In this study, ophthalmologists from Europe and the USA successfully used a remotely programmed laser to treat retinal diseases across continents. The work involved planning and executing the retinal laser treatment through remote guidance and real-time communication. Each treatment was conducted successfully with precise laser spot application and without any technical issues. Subsequent examinations at three weeks confirmed positive outcomes for every patient. Remotely programmed laser treatment appeared feasible and successful, offering potential benefits for global collaboration in retina care, especially in areas with limited access to expert supervision.
© The Author(s), 2025.