Selective retina therapy (SRT) of chronic subfoveal fluid after surgery of rhegmatogenous retinal detachment: three case reports

Koinzer, Stefan; Elsner, Holger-Andreas; Klatt, C.; Pörksen, E.; Brinkmann, Ralf; Birngruber, Reginald; Roider, Johann

doi:10.1007/s00417-008-0860-1

Cited by 39 publications

(26 citation statements)

References 20 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…9 By applying laser pulses that are shorter than the thermal confinement time of the absorbing structure, the risk of thermal damage to the surrounding healthy retina and choroid is reduced. [10][11][12] The origin of the selectivity for RPE cells relies on the formation of very short-lived (ls, microseconds) vapor bubbles generated around the strongly absorbing melanosomes within the cells, which disrupt the cellular membrane due to the temporarily strongly increased cell volume. 13 Several experimental studies have confirmed the safety of SRT and have established the therapeutic range of laser irradiation for retinal tissue.…”

mentioning

confidence: 99%

Retinal Pigment Epithelium Responses to Selective Retina Therapy in Mouse Eyes

Kim

Jang

Lee

et al. 2016

Invest. Ophthalmol. Vis. Sci.

Self Cite

View full text Add to dashboard Cite

Citation: Kim HD, Jang SY, Lee SH, et al. Retinal pigment epithelium responses to selective retina therapy in mouse eyes. Invest Ophthalmol Vis Sci. 2016;57:3486-3495. DOI:10.1167/iovs.16-19508 PURPOSE. To investigate the characteristics of retinal pigment epithelium (RPE) and retinal damage induced by selective retina therapy (SRT) in mice, and to elucidate longitudinal changes in RPE cells.METHODS. C57BL/6J mice received SRT and continuous-wave laser photocoagulation (cwPC). The cell death pattern was evaluated using TUNEL assay, and proliferative potential of the RPE cells was evaluated using 5-ethynyl-2 0 -dexoyuridine (EdU) assay. To investigate the cell-cell integrity of RPE cells, b-catenin staining was performed. The number and hexagonality of RPE cells in the SRT-treated area were estimated using a Voronoi diagram with time periods of 3 hours to 14 days. Antibodies to microphthalmia-associated transcription factor (MiTF) and orthodenticle homeobox 2 (Otx2) were used to confirm the specific characteristics of RPE cells in the SRT-treated area.RESULTS. The number of TUNEL-positive cells located in the neural retina was significantly lower in lesions treated with SRT compared to those treated with cwPC. EdU-positive RPE cells were first detected 3 to 12 hours after SRT, and increased until 3 to 7 days after SRT. bcatenin staining showed that hexagonality was compromised and subsequently, RPE cells expanded in size within the targeted location. The number of RPE cells in SRT lesions decreased gradually until 12 hours after SRT and recovered by 14 days. Upregulated expression of MiTF and Otx2 was observed for 2 weeks in the SRT lesions.CONCLUSIONS. Selective retina therapy seems to induce selective RPE damage without collateral thermal injury in the neural retina. Furthermore, SRT-treated lesions recovered by proliferation of RPE cells that were present in the treated lesions and by expansion of adjacent RPE cells.Keywords: microphthalmia-associated transcription factor (MiTF), orthodenticle homeobox 2 (Otx2), retinal pigment epithelium, selective retina therapy L aser photocoagulation is a mainstay for the treatment of several retinal conditions associated with retinal pigment epithelium (RPE) dysfunction. 1-4 Continuous-wave laser photocoagulation (cwPC) has been used in the treatment of various macular diseases, such as diabetic macular edema (DME), agerelated macular degeneration, and central serous chorioretinopathy (CSC), over several decades.2-4 Light energy from cwPC is converted into heat in the melanosomes of RPE cells. By heat diffusion, this thermal energy not only damages the RPE but also results in collateral damage of surrounding components, particularly overlying photoreceptors, Bruch's membrane, and choriocapillaries. [5][6][7][8] This is a desired effect because it induces scar formation, which prevents further retinal detachment in retinal holes, and damages photoreceptors during panretinal photocoagulation, which is thought to preserve the central macula in diabetic retinopathy. Howev...

show abstract

mentioning

confidence: 99%

Retinal Pigment Epithelium Responses to Selective Retina Therapy in Mouse Eyes

Kim

Jang

Lee

et al. 2016

Invest. Ophthalmol. Vis. Sci.

Self Cite

View full text Add to dashboard Cite

show abstract

“…Despite this several treatment options have been described. [9][10][11][12] Several aetiological or associated factors have been identified: type of surgery performed, pre-operative macula involvement, position, extent, and duration of the retinal detachment. In one series it was reported that persistent submacular fluid was found in 36% of cases that were clinically considered to have a fully attached macula prior to surgery; which raised the possibility that the fluid is exudative rather than persistent subretinal fluid from the retinal detachment.…”

Section: Discussionmentioning

confidence: 99%

Persistent subfoveolar fluid following retinal detachment surgery: an SD-OCT guided study on the incidence, aetiological associations, and natural history

Tee

Veckeneer

Laidlaw

2016

Eye

View full text Add to dashboard Cite

Purpose To investigate the incidence and natural history of persistent subfoveolar fluid (PSF) following surgery for macular off rhegmatogenous retinal detachment and the effect of PSF on photoreceptor structure and final visual acuity. Methods Retrospective study of 61 cases with post-operative optical coherence tomography (OCT) performed within 12 weeks of surgery. Based on aetiology, cases were categorized into tractional retinal tears (TRT) group or atrophic round holes and dialyses (RHD) group to investigate the incidence and duration of PSF. A Kaplan-Meier graph was plotted to compare survival time of subfoveolar fluid for both groups. Following secondary reclassification of cases into those with and without PSF, the effect of PSF on final visual acuity and photoreceptor structure was investigated with Mann-Whitney U-test used for comparison. Spearman's correlation testing was used to probe associations between time to recorded resolution of PSF with final visual acuity and photoreceptor structure. Results Incidence of PSF was greater in the RHD group and persisted for longer compared with TRT group. No detectable adverse effect of PSF on final visual acuity was seen however an individual case of severe photoreceptor atrophy was observed. No significant correlation was found between the time to recorded resolution of PSF and the final visual acuity or to photoreceptor grading scores. Conclusions A difference in incidence of PSF was detected between the aetiological groups. PSF was ubiquitous and slow to resolve in the RHD group. Most cases of PSF resolve without adverse sequelae; however, progressive photoreceptor atrophy and sub-optimal visual outcome may result in a minority.

show abstract

“…8,[10][11][12][13]43,44 In those studies, lesion intensities were controlled by a variety of inconsistent criteria, which produced different outcomes, makes lesion characteristics incompatible and prevents meta-analyses. Automatic laser exposure control as presented in this study is, to the authors' knowledge, the only functional way to accurately create well-defined lesion intensities above and below the visibility threshold.…”

Section: Discussionmentioning

confidence: 99%

“…Pilot studies have collected evidence that subvisible treatment and SRT are clinically effective. 8,[10][11][12][13] The term subvisible is commonly applied for lesions that are at least ophthalmoscopically invisible during the treatment. Due to inter-and intraindividual variation of light transmission, light absorption, and tissue sensitivity, the biological effect of a laser irradiation cannot be predicted from laser parameters alone, such as power, irradiation time, and irradiation diameter.…”

Section: Introductionmentioning

confidence: 99%

Temperature-Controlled Retinal Photocoagulation Reliably Generates Uniform Subvisible, Mild, or Moderate Lesions

Koinzer

Baade

Schlott

et al. 2015

Trans. Vis. Sci. Tech.

Self Cite

View full text Add to dashboard Cite

Purpose: Conventional retinal photocoagulation produces irregular lesions and does not allow reliable control of ophthalmoscopically invisible lesions. We applied automatically controlled retinal photocoagulation, which allows to apply uniform lesions without titration, and aimed at five different predictable lesion intensities in a study on rabbit eyes.Methods: A conventional 532-nm photocoagulation laser was used in combination with a pulsed probe laser. They facilitated real-time fundus temperature measurements and automatic exposure time control for different predefined time/ temperature dependent characteristics (TTC). We applied 225 control lesions (exposure time 200 ms) and 794 TTC lesions (5 intensities, exposure times 7-800 ms) in six rabbit eyes with variable laser power (20-66.4 mW). Starting after 2 hours, we examined fundus color and optical coherence tomographic (OCT) images over 3 months and classified lesion morphologies according to a seven-stage OCT classifier.Results: Visibility rates in funduscopy (OCT) after 2 hours were 17% (68%) for TTC intensity group 1, 38% (90%) for TTC group 2 and greater than 94% (.98%) for all consecutive groups. TTC groups 1 through 4 correlated to increasing morphological lesion intensities and increasing median funduscopic and OCT diameters. Group 5 lesions were as large as, but more intense than group 4 lesions.Conclusions: Automatic, temperature controlled photocoagulation allows to apply predictable subvisible, mild, or moderate lesions without manual power titration.Translational Relevance: The technique will facilitate standardized, automatically controlled low and early treatment of diabetic retinopathy study (ETDRS) intensity photocoagulation independently of the treating physician, the treated eye and lesion location.

show abstract

Selective retina therapy (SRT) of chronic subfoveal fluid after surgery of rhegmatogenous retinal detachment: three case reports

Cited by 39 publications

References 20 publications

Retinal Pigment Epithelium Responses to Selective Retina Therapy in Mouse Eyes

Retinal Pigment Epithelium Responses to Selective Retina Therapy in Mouse Eyes

Persistent subfoveolar fluid following retinal detachment surgery: an SD-OCT guided study on the incidence, aetiological associations, and natural history

Temperature-Controlled Retinal Photocoagulation Reliably Generates Uniform Subvisible, Mild, or Moderate Lesions

Contact Info

Product

Resources

About