Tissue effects of subclinical diode laser treatment of the retina

被引:60
作者
Pollack, JS [1 ]
Kim, JE [1 ]
Pulido, JS [1 ]
Burke, JM [1 ]
机构
[1] Med Coll Wisconsin, Dept Ophthalmol, Milwaukee, WI 53226 USA
关键词
D O I
10.1001/archopht.116.12.1633
中图分类号
R77 [眼科学];
学科分类号
100212 ;
摘要
Objective: To determine whether consistent tissue effects are obtained when laser lesions are produced with a commercially available diode laser that are near the limit of clinical detection at the time of treatment. Methods: Continuous-wave or micropulse diode laser was used to produce clinically undetectable (subthreshold) or barely detectable (threshold) retinal lesions in pigmented rabbits. Tissue effects at intervals after treatment were determined in retinal pigment epithelial (RPE) whole mounts by fluorescence microscopy, and in sections of retina and RPE by light and electron microscopy. Results: Continuous-wave and micropulse laser lesions that were originally clinically undetectable were detectable as zones of pigment mottling after 5 days. By microscopy, compaction and/or swelling was seen in the outer retina, and cells in the RPE monolayer became heterogeneous in size, shape, and pigmentation, but the tissue responses in the outer retina and RPE were variable even within and among lesions in the same eye. Conclusions: Subthreshold energies used to create both continuous-wave and micropulse laser lesions produced variable effects on the RPE and the overlying neurosensory retina. It appears that, near the minimum effective dose of laser irradiation, individual RPE cell heterogeneity becomes detectable as variability in sensitivity to laser injury. Clinical Relevance: As laser energy is reduced to limit collateral tissue damage in clinical applications, it may be difficult to generate reproducible lesions because of heterogeneity among individual cells.
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收藏
页码:1633 / 1639
页数:7
相关论文
共 21 条
[1]   SELECTIVE PHOTOTHERMOLYSIS - PRECISE MICROSURGERY BY SELECTIVE ABSORPTION OF PULSED RADIATION [J].
ANDERSON, RR ;
PARRISH, JA .
SCIENCE, 1983, 220 (4596) :524-527
[2]  
Berger JW, 1997, LASER SURG MED, V20, P409, DOI 10.1002/(SICI)1096-9101(1997)20:4<409::AID-LSM6>3.0.CO
[3]  
2-U
[4]  
BRANCATO R, 1989, INVEST OPHTH VIS SCI, V30, P1504
[5]  
BURKE JM, 1998, RETINAL PIGMENT EPIT, P103
[6]  
CHONG LP, 1992, INVEST OPHTH VIS SCI, V33, P722
[7]  
CHONG LP, 1993, INVEST OPHTH VIS SCI, V34, P960
[8]  
FOLK JC, 1997, AM ACAD OPHTHALMOLOG, V11
[9]   The treatment of macular disease using a micropulsed and continuous wave 810-nm diode laser [J].
Friberg, TR ;
Karatza, EC .
OPHTHALMOLOGY, 1997, 104 (12) :2030-2038
[10]  
GERDES J, 1991, AM J PATHOL, V138, P867