Photocoagulation Scar Expansion After Laser Therapy for Choroidal Neovascularization in Degenerative Myopia

Brancato, Rosario; Pece, Alfredo; Avanza, P.; Radrizzani, E.

doi:10.1097/00006982-199010000-00002

Cited by 104 publications

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“…The expansion of a laser scar is responsible for the loss of initial gain [126]. This late failure is seen in 92–100% of the treated eyes [16,121,122,123,124].…”

Section: Treatment Of Myopic Cnvmentioning

confidence: 99%

Myopic Maculopathy: A Review

Silva

2012

Ophthalmologica

108

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Pathological myopia is a major cause of irreversible vision loss and is the fourth to ninth most frequent cause of blindness in the world. Choroidal neovascularization (CNV) secondary to pathological myopia is the leading cause of vision impairment in patients younger than 50 years. New scientific contributions have been made to the understanding of high myopia and associated CNV. New treatments have been used in recent years, and the results are still controversial. This paper is an updated review of pathological myopia – its definition and progression, epidemiology and genetics – and a review of myopic CNV including the natural history, epidemiology, risk factors, pathogenic mechanisms and treatment.

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“…The expansion of a laser scar is responsible for the loss of initial gain [126]. This late failure is seen in 92–100% of the treated eyes [16,121,122,123,124].…”

Section: Treatment Of Myopic Cnvmentioning

confidence: 99%

Myopic Maculopathy: A Review

Silva

2012

Ophthalmologica

108

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“…We know, as reported in the literature by one of the authors since 1990 [25], that atrophic changes after treatment are likely to occur after laser therapy or PDT [32], but we think that fibrotic more than RPE changes are responsible for VA worsening in our study.…”

Section: Discussionmentioning

confidence: 67%

“…Traditionally, before the anti-VEGF and PDT era, the primary goal using lasers in the treatment of extrafoveal and juxtafoveal myopic CNV was to cause a focal photocoagulation of abnormal choroidal new vessels by change of light energy into thermal energy. Nevertheless, recurrent CNV that grows through the central fovea is untreatable with laser photocoagulation, and the posttreatment atrophy from the laser scar usually enlarges over time and may cause central scotoma and reading difficulties when the FAZ is affected [25]. …”

Section: Discussionmentioning

confidence: 99%

A Long-Term Study of Photodynamic Therapy with Verteporfin for Choroidal Neovascularization at the Edge of Chorioretinal Atrophy in Pathologic Myopia

Pece¹,

Milani

Isola³

et al. 2011

Ophthalmologica

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Purpose: To evaluate the effects of verteporfin photodynamic therapy (PDT) on choroidal neovascularization (CNV) at the edge of chorioretinal atrophy in eyes with pathologic myopia. Procedures: Twenty eyes of 20 consecutive patients were treated according to Verteporfin in Photodynamic Therapy criteria. The patients were divided into 3 groups based on CNV location and were followed up with clinical and fluorescein angiographic examinations to evaluate visual acuity (VA) changes and number of treatments. Results: The mean follow-up was 35 months. In group 1 (n = 8; subfoveal CNV), VA declined from 20/73 (0.56 ± 0.26 logMAR) to 20/115 (0.76 ± 0.30 logMAR; p = 0.192). In group 2 (n = 6; juxtafoveal CNV), VA improved from 20/69 (0.54 ± 0.25 logMAR) to 20/46 (0.36 ± 0.16 logMAR; p = 0.176). In group 3 (n = 6; extrafoveal CNV), VA worsened from 20/50 (0.40 ± 0.21 logMAR) to 20/91 (0.66 ± 0.49 logMAR; p = 0.292). Conclusions: PDT showed inhibitory effects on myopic CNV arising at the edge of chorioretinal atrophy, especially in young adult myopic eyes with juxtafoveal neovascular membranes.

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“…Consequently, it is difficult to ascertain whether an increasing CDR in post PRP treated eyes is due to glaucoma, diabetes related ischemia or simply a non-progressive injury secondary to the PRP itself. Past studies used unsophisticated or non-dedicated imaging to measure retinal nerve fiber layers (RNFL) [1,4,5,[7][8][9][10][11][12][13][14][15][16][17]. Ours is the first to use highly reproducible High Definition Spectral Domain Optical Coherence Tomography (SDOCT) of the optic nerve head (ONH) by both Cirrus (Carl Zeiss Meditec Inc, Dublin, CA) and Spectralis (Heidelberg Engineering, Heidelberg Germany).…”

Section: Introductionmentioning

confidence: 99%

“…Likewise, ONHs in eyes treated with PRP are more likely to be graded as abnormal, but their appearance is not necessarily glaucomatous and may be related to thinning of the RNFL [10]. In contrast, Kim et al concluded that there was no detectable change to the optic nerve following PRP [18].…”

Section: Introductionmentioning

confidence: 99%

The Effects of PASCAL Panretinal Photocoagulation on the Peripapillary Retinal Nerve Fiber Layer

Mohla¹,

Mathur²

2016

J Clin Exp Ophthalmol

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Purpose: To investigate the effects of Pascal (Topcon Medical Laser Systems, Inc. Oakland, NJ) pan-retinal photocoagulation (PRP) on the optic nerve head (ONH).Method: This was a prospective case control study comparing 3 groups of patients seen in the diabetic retinopathy (DR) clinics, without any coexistent optic nerve pathology.Group A patients had proliferative or severe non proliferative DR necessitating PRP during the study period. Group B patients had mild or moderate DR and did not require PRP throughout the study period. Group C patients had standard retinal laser (green argon or frequency doubled YAG) PRP at least 2 years ago. All the 3 Groups had retinal oxygenation measurements and retinal vessel caliber readings by Oxymap T1(Oxymap, Reykjavik, Iceland), optic disc stereophotographs, high definition optical coherence tomography (HD-OCT) scans of the ONH by both Cirrus (Carl Zeiss Meditec Inc, Dublin, CA) and Spectralis (Heidelberg Engineering, Heidelberg Germany). These were performed prior to PRP at baseline, then at 3, 6, and 12 months post PRP for group A and at baseline, 3, 6, and 12 months for groups B and C. Paired t-test was used to assess the mean changes in parameters from baseline for each group.Results: A total of 90 patients were recruited including 27 in Group A, 31 in Group B and 32 in Group C. At baseline, the average retinal nerve fibre layer (RNFL) was significantly thicker in group A compared to group B (102.0 ± 16.8 vs. 89.5 ± 11.6 μm, p=0.001) and group C (88.6 ± 11.2 μm, p=0.001) respectively. At 3 months, Group A exhibited a significant increase in the Cirrus average RNFL thickness (5.60 ± 8.54 µ, p=0.003) when compared to baseline. At 6 months, the average RNFL reverted to baseline values (p=0.89), and remained stable at 12 months (p=0.85). There was no significant change noted in the average Cirrus RNFL thickness at 3 and 6 months in Group B. At 12 months, the average RNFL was significantly thinner compared to baseline (-6.68 ± 8.10; p=0.005). In Group C, the average RNFL remained stable from baseline through to month 12 (p>0.05 at the three timepoints). No significant changes were noted in the average Spectralis RNFL thickness at any timepoints in each of the three groups.Oxygen saturation dropped in all 3 groups at 3 months, being significant only in group B (-2.05 ± 4.20%, p=0.03). Conclusion:In eyes treated with Pascal PRP, there was an initial increase in the retinal nerve fibre layer at the optic nerve head at 3 months followed by a thinning back to baseline values at 6 months which then remained stable up to 12 months. Hence the Pascal PRP did not have a significant effect on the nerve fibre layer at 12 months.Keywords: Pascal panretinal photocoagulation; Optic nerve head; Retinal nerve fibre layer thickness; Retinal oximetry; Diabetic retinopathy SummaryIn this study, we investigated the effects of Pascal (Topcon Medical Laser Systems, Inc. Oakland, NJ) pan-retinal photocoagulation (PRP) on the optic nerve head (ONH). This was a prospective case control study c...

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Photocoagulation Scar Expansion After Laser Therapy for Choroidal Neovascularization in Degenerative Myopia

Cited by 104 publications

References 0 publications

Myopic Maculopathy: A Review

Myopic Maculopathy: A Review

A Long-Term Study of Photodynamic Therapy with Verteporfin for Choroidal Neovascularization at the Edge of Chorioretinal Atrophy in Pathologic Myopia

The Effects of PASCAL Panretinal Photocoagulation on the Peripapillary Retinal Nerve Fiber Layer

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