Transluminal Nd:YAG laser embolysis - A reasonable method to reperfuse occluded branch retinal arteries
Transluminal Nd:YAG laser embolysis - A reasonable method to reperfuse occluded branch retinal arteries
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DOI：
10.2298/vsp130511056s
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发表时间：
2014-11-01
影响因子：
0.2
通讯作者：
Munteanu, Mihnea
中科院分区：
文献类型：
--
作者：
Stanca, Horia T.;Petrovic, Zarko;Munteanu, Mihnea
导论.视网膜中央动脉阻塞（CRAO）和视网膜分支动脉阻塞（BRAO）是视网膜部分或完全缺血导致视力突然丧失的疾病，目前尚无有效的治疗方法。经腔Nd：YAG激光栓塞术是治疗视网膜血管阻塞性疾病的一种方法。主要适应症为视网膜分支动脉阻塞伴可见栓子，对于视网膜中央动脉阻塞，该技术几乎不适用。该方法的原理包括使用1064 rim Nd：YAG激光聚焦于栓子表面进行血管内栓子破裂。病例报告。我们报告了5例BRAO，3例颞下BRAO和2例颞上BRAO，均采用TYE治疗，结果各不相同。所有患者的BRA内均存在可见栓子，激光应用直接输送至栓子。结论尽管我们对这种治疗方法有短期经验，但我们可以继续说，尽可能接近闭塞开始的栓子破坏时刻对于恢复视力是决定性的，并且在大多数情况下，正确应用程序上级观察。TYE的全球经验仍然有限，但该技术在治疗由视盘表面可见栓子引起的CRAO时似乎也是可行的。这当然需要随机试验来精确确定TYE在视网膜阻塞病理治疗中的作用，尽管相对较少的正确诊断病例影响了这一目标。在所有情况下，TYE的风险必须与继发于视网膜动脉阻塞的严重和永久性视力丧失的可能性进行权衡。
Introduction. Central retinal artery occlusion (CRAO) and branch retinal artery occlusion (BRAO) result in partial or complete retinal ischemia and sudden loss of vision; at this moment, there is no effective therapy for CRAO and BRAO. Transluminal Nd:YAG laser embolysis (TYE) represents a therapeutic approach used for retinal vascular occlusive diseases. The main indication is branch retinal artery occlusion with visible embolus; for central retinal artery occlusion this tehnique is hardly applicable. The principle of this method consists of intravascular embolus breakage using the 1064 rim Nd:YAG laser, focused on the embolus surface. Case report. We presented 5 cases with BRAO, 3 with infero-temporal and 2 with supero-temporal BRAO, all of them treated with TYE, with variable results. All the patients had a visible embolus within the BRA, the laser applications being delivered directly to the embolus. Conclusion. Despite our short-term experience regarding this therapeutical approach, we can resume that the moment of emboli distruction, as close as possible to the onset of the occlusion, is decisive for regaining vision and that applying the procedure correctly is superior to observation in most cases. Worldwide experience with TYE is still limited, but the technique seems feasible also when treating CRAO caused by visible emboli on the optic disc surface. This most certainly calls for random trials for identifying precisely the role of TYE in treatment of retinal occlusion pathology, though the relatively small number of properly diagnosed cases affects this objective. In all cases, the risks of TYE must be weighed against the possibility of severe and permanent loss of vision secondary to retinal artery occlusions.