Spatial and Spectral Imaging of Retinal Laser Photocoagulation Burns
Spatial and Spectral Imaging of Retinal Laser Photocoagulation Burns
复制标题
DOI：
10.1167/iovs.10-6309
复制
发表时间：
2011-02-01
影响因子：
4.4
通讯作者：
Stanga, Paulo E.
中科院分区：
文献类型：
--
作者：
Muqit, Mahiul M. K.;Denniss, Jonathan;Stanga, Paulo E.
目的。使用傅里叶域光学相干断层扫描 (FD OCT)、自发荧光 (AF)、荧光素血管造影 (FA) 和多光谱成像，关联短脉冲至长脉冲 532 nm Nd:YAG 视网膜激光损伤的体内空间和光谱形态变化。方法。研究人员对十只患有未经治疗的增殖前或增殖性糖尿病视网膜病变的眼睛进行了研究。将 20、100 和 200 毫秒的激光烧伤滴定网格应用于鼻视网膜，并滴定激光注量，以产生四个等级的激光损伤可见度：亚可见（SV）、几乎不可见（BV，浅灰色）、阈值（TH，灰白色）和阈上（ST，白色）。 AF、FA、FD-OCT 和多光谱成像在激光前 1 周、激光后 1 小时、4 周、3 个月和 6 个月进行。多光谱成像测量相对组织氧浓度。结果。激光烧伤可见度和病变大小根据固定能量密度水平呈线性关系增加。在固定脉冲持续时间下，6 个月内病变大小呈半对数增加。 20 毫秒时，6 个月后所有级别的激光损伤尺寸均显着减小：SV，51%；细菌价值，54%； TH，49%； ST，50%（P < 0.001），视网膜色素上皮增生和光感受器充盈。与 100 毫秒和 200 毫秒损伤相比，20 毫秒时光感受器内节/外节连接层愈合。 6 个月时检测到激光滴定区域内的平均组织氧合（范围为 4 至 6 个单位）和整个激光损伤处的氧浓度（P < 0.01）显着增加。结论。对于接受激光治疗的患者来说，与随着时间的推移较长的脉冲持续时间相比，20 毫秒时的组织氧合作用可能会得到改善，烧伤形态的可预测性更高，烧伤愈合反应的空间定位更佳。 （投资眼科可见科学。2011；52：994-1002）DOI：10.1167/iovs.10-6309
PURPOSE. To correlate in vivo spatial and spectral morphologic changes of short- to long-pulse 532 nm Nd:YAG retinal laser lesions using Fourier-domain optical coherence tomography (FD OCT), autofluorescence (AF), fluorescein angiography (FA), and multispectral imaging.METHODS. Ten eyes with treatment-naive preproliferative or proliferative diabetic retinopathy were studied. A titration grid of laser burns at 20, 100, and 200 milliseconds was applied to the nasal retina and laser fluence titrated to produce four grades of laser lesion visibility: subvisible (SV), barely visible (BV, light-gray), threshold (TH, gray-white), and suprathreshold (ST, white). The AF, FA, FD-OCT, and multispectral imaging were performed 1 week before laser, and 1 hour, 4 weeks, and 3 and 6 months post-laser. Multi-spectral imaging measured relative tissue oxygen concentration.RESULTS. Laser burn visibility and lesion size increased in a linear relationship according to fixed fluence levels. At fixed pulse durations, there was a semilogarithmic increase in lesion size over 6 months. At 20 milliseconds, all grades of laser lesion were reduced significantly in size after 6 months: SV, 51%; BV, 54%; TH, 49%; and ST, 50% (P < 0.001), with retinal pigment epithelial proliferation and photoreceptor infilling. At 20 milliseconds, there was healing of photoreceptor inner segment/outer segment junction layers compared with 100- and 200-millisecond lesions. Significant increases in mean tissue oxygenation (range, four to six units) within the laser titration area and in oxygen concentration across the laser lesions (P < 0.01) were detected at 6 months.CONCLUSIONS. For patients undergoing therapeutic laser, there may be improved tissue oxygenation, higher predictability of burn morphology, and more spatial localization of healing responses of burns at 20 milliseconds compared with longer pulse durations over time. (Invest Ophthalmol Vis Sci. 2011;52:994-1002) DOI:10.1167/iovs.10-6309