Restoration of retinal morphology and residual scarring after photocoagulation

Restoration of retinal morphology and residual scarring after photocoagulation

Author Lavinsky, Daniel Autor UNIFESP Google Scholar
Cardillo, Jose A. Autor UNIFESP Google Scholar
Mandel, Yossi Google Scholar
Huie, Philip Google Scholar
Melo, Luiz A. Autor UNIFESP Google Scholar
Farah, Michel Eid Autor UNIFESP Google Scholar
Belfort, Rubens Junior Autor UNIFESP Google Scholar
Palanker, Daniel Google Scholar
Institution Universidade Federal de São Paulo (UNIFESP)
Stanford Univ
Abstract Abstract.Purpose: To study healing of retinal laser lesions in patients undergoing PRP using SD-OCT.Methods: Moderate, light and barely visible retinal burns were produced in patients with proliferative diabetic retinopathy scheduled for PRP using 100-, 20- and 10-ms pulses of 532-nm laser, with retinal spot sizes of 100, 200 and 400 mu m. Lesions were measured with OCT at 1 hr, 1 week, 1, 2, 4, 6, 9 and 12 months. OCT imaging was correlated with histology in a separate study in rabbits.Results: Lesions produced by the standard 100-ms exposures exhibited steady scarring, with the damage zone stabilized after 2 months. for 400- and 200-mu m spots and 100-ms pulses, the residual scar area at 12 months was approximately 50% of the initial lesion size for moderate, light and barely visible burns. in contrast, lesions produced by shorter exposures demonstrated enhanced restoration of the photoreceptor layer, especially in smaller burns. With 20-ms pulses, the damage zone decreased to 32%, 24% and 20% for moderate, light and barely visible burns of 400 mu m, respectively, and down to 12% for barely visible burns of 200 mu m. in the 100-mu m spots, the residual scar area of the moderate 100-ms burns was 41% of the initial lesion, while barely visible 10-ms burns contracted to 6% of the initial size. Histological observations in rabbits were useful for proper interpretation of the damage zone boundaries in OCT.Conclusions: Traditional photocoagulation parameters (400 mu m, 100 ms and moderate burn) result in a stable scar similar in size to the beam diameter. Restoration of the damaged photoreceptor layer in lighter lesions produced by shorter pulses should allow reducing the common side-effects of photocoagulation such as scotomata and scarring.
Keywords optical coherence tomography
laser photocoagulation
wound healing
Language English
Sponsor Pan-American Ophthalmological Foundation
Retina Research Foundation
Date 2013-06-01
Published in Acta Ophthalmologica. Hoboken: Wiley-Blackwell, v. 91, n. 4, p. E315-E323, 2013.
ISSN 1755-375X (Sherpa/Romeo, impact factor)
Publisher Wiley-Blackwell
Extent E315-E323
Access rights Open access Open Access
Type Article
Web of Science ID WOS:000334387500015

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