Visualization of Subthreshold Micropulse Diode Laser Photocoagulation by Scanning Laser Ophthalmoscopy in the Retro Mode
Visualization of Subthreshold Micropulse Diode Laser Photocoagulation by Scanning Laser Ophthalmoscopy in the Retro Mode
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DOI：
10.1016/j.ajo.2010.06.022
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发表时间：
2010-12-01
影响因子：
4.2
通讯作者：
Yamaguchi, Tatsuo
中科院分区：
文献类型：
--
作者：
Ohkoshi, Kishiko;Tsuiki, Eiko;Yamaguchi, Tatsuo
目的：评价采用新型暗视野光圈的扫描激光眼底镜检查阈值以下半导体激光微脉冲光凝产生的激光斑点的有效性。设计：干预性病例系列。方法：地点：机构。患者：连续8例(8只眼)临床明显的糖尿病黄斑水肿患者和1例(1只眼)因分支静脉阻塞引起的黄斑水肿患者接受阈值下半导体激光微脉冲光凝治疗。分别在阈值以下激光光凝前和激光光凝后即刻扫描激光眼底镜图像。在微脉冲模式下，在3组不同的条件下，以15%的占空比进行0.2秒的激光应用：条件I是在连续波模式中阈值功率为200%的200µm光斑，条件II是300%阈值功率的200µm光斑，以及条件III是250%或300%阈值功率的125µm光斑。分别在彩色图像和扫描激光检眼镜(F-10，NIDEK，Gamagori，日本)上对激光治疗区域进行监测。结果：阈值下激光光凝后，所有患者的彩色图像上均未见明显的激光瘢痕。激光扫描检眼镜在条件I治疗后无明显变化，但条件II和条件III在7例患者中有5例在激光应用部位出现黑斑。结论：激光扫描检眼镜可用于检测阈值以下微脉冲激光的应用部位。激光检眼镜复查发现的暗斑可能与激光照射后色素上皮肿胀有关。该方法对亚阈值半导体激光微脉冲光凝产生的不可见光斑的确定具有一定的参考价值。《眼科杂志》2010；150：856-862。(C)2010年，爱思唯尔公司保留所有权利。)
PURPOSE: To assess the efficacy of scanning laser ophthalmoscopy in the retro mode, employing a new dark-field aperture, for detecting laser spots created by subthreshold diode laser micropulse photocoagulation.DESIGN: Interventional case series.METHODS: SETTING: Institutional. PATIENTS: Eight consecutive patients (8 eyes) with clinically significant diabetic macular edema and 1 patient (1 eye) with macular edema attributable to branch vein occlusion underwent subthreshold diode laser micropulse photocoagulation. Scanning laser ophthalmoscopy images were obtained before and immediately after subthreshold laser photocoagulation. Application of the laser was done under 3 different sets of conditions with a 15% duty cycle for 0.2 seconds in the micropulse mode: condition I was 200-mu m spots at 200% of the threshold power in the continuous wave mode, condition II was 200-mu m spots at 300%, and condition III was 125-mu m spots at 250% or 300%. The laser-treated area was monitored on both color images and by scanning laser ophthalmoscopy (F-10, NIDEK, Gamagori, Japan).RESULTS: Immediately after subthreshold laser photocoagulation, there were no obvious laser scars affecting the treated area in any of the patients on color images. Scanning laser ophthalmoscopy with a diode laser in the retro mode showed no obvious changes after treatment under condition I. However, conditions II and III resulted in dark spots at the sites where the laser had been applied in 5 out of 7 patients.CONCLUSIONS: Scanning laser ophthalmoscopy in the retro mode is useful to detect sites of subthreshold micropulse laser application. The dark spots detected by retro mode scanning laser ophthalmoscopy are probably related to swelling of the pigment epithelium after laser application. This method is useful to confirm the invisible spots created by subthreshold diode laser micropulse photocoagulation. (Am J Ophthalmol 2010;150:856-862. (C) 2010 by Elsevier Inc. All rights reserved.)