This book discusses the new era of modern retinal laser therapy and its clinical applications. While the photocoagulation era universally presupposed the therapeutic necessity of laser-induced retinal damage, the modern retinal laser therapy is equally opposed to this idea. The evidence for this sea-change in the understanding of retinal laser is well presented within this book, and the conceptual and clinical consequences are discussed with particular emphasis on the emergence of retinal laser therapy as the first reasonable preventive and restorative intervention for the most important retinal disorders. Finally, the future of modern retinal laser therapy is highlighted with respect to coming technological advances, remaining challenges, and the place of retinal laser in the management of retinal disease.
This book is an essential resource for all ophthalmic residents and clinicians seeking a clear and concise guide to modern retinal laser therapy in their everyday practice.
Author(s): Andrzej Grzybowski, Jeffrey K. Luttrull, Igor Kozak
Publisher: Springer
Year: 2023
Language: English
Pages: 356
City: Cham
Contents
Abbreviations
1 Book Introduction
References
2 History of Lasers in Ophthalmology
The Idea of Photocoagulation
Burning Glass
Solar Blindness
Gerd Meyer-Schwickerath (1920–1992)
José Morón Salas (1918–2000)
Other Important Contributors
The Complicated Beginnings of Laser
Beginnings of Lasers in Ophthalmology
Conclusions
References
3 Basics of Laser Use in Ophthalmology
Photochemical Interactions
Photothermal Interactions
Photomechanical/Ionising Interactions
References
4 Retinal Laser Treatment for Age-Related Macular Degeneration (AMD)
Introduction
Conventional Suprathreshold Macular Photocoagulation (MPC)
Overview
Prophylactic MPC, or “Laser for Drusen”
MPC for Neovascular AMD
Subfoveal CNV
Transpupillary Thermotherapy (TTT)
Photodynamic Therapy (PDT)
Feeder Vessel Treatment
A Newer Approach to Drusen Reduction: Short-Pulse Lasers
Pattern Scanning Laser (PASCAL)
Selective Retinal Laser Therapy (SRT)
Nanosecond Laser (“2RT”)
Micropulse Laser (MPL)
Synthesis
References
5 Lasers in Diabetic Retinopathy
Introduction
Pathomechanism of Diabetic Retinopathy in the Context of Laser—Tissue Interaction
Clinical Picture and Classifications of Diabetic Retinopathy
Diagnostics
Diagnostic Tests for Macular Area
Diagnostics of the Retinal Periphery
Principles of Management of DR
Treatment of Diabetic Retinopathy Itself
Comments
Treatment Algorithms for DME
General Remarks
Laser Treatment of Diabetic Retinopathy and Diabetic Macular Edema
Contemporary Application of Laser Photocoagulation in the Treatment of DR
PRP with Multispot Laser
Strategies for PRP Treatment
The Number of Spots in Panretinal Photocoagulation
Lenses for Scatter Laser Therapy
Panretinal Photocoagulation Intensity
PRP in Subthreshold Mode
PPV Versus PRP for PDR
Combined Therapies: Laser Plus Anti-VEGF
Laser Treatment in DME
Subthreshold Laser Treatment
Combined SML and Anti VEGF Treatment
Complications of PRP and Focal Laser Treatment
Complications of SML Treatment
References
6 Lasers in the Treatment of Central Serous Chorioretinopathy
Incidence
Risk Factors
Different Concepts of CSCR Pathomechanism
Retinal Pigment Epithelium (RPE) Dysfunction
Choroidal Dysfunction
Choroid Morphology Abnormalities
Mineralocorticoid Pathway
Clinical Picture, Diagnostics and Classification
Classification
Diagnostics
Fundus Autofluorescence
SD-OCT/SS-OCT
Angio-OCT (OCTA)
Fluorescein Angiography (FA)
Indocyanine Green Angiography (ICGA)
Differential Diagnosis
Polipoidal Choroidal Vasculopathy (PCV)
Pachychoroid Neovasculopathy
Age Related Macular Degeneration AMD
Neovascular AMD (nAMD)
Non-exudative Form
High Myopia
Angioid Streaks
Dome Shaped Macula (DSM)
Optic Disc Pit (ODP)
Ocular Tumors
Posterior Scleritis
Vogt-Koyanagi-Harada (VKH) Disease
Inflammatory Diseases
Vitelliform Lesions
Macular Edema (ME) Due to Vascular Retinal Diseases
The Course of CSCR
Laser Treatment of CSCR
Laser Retinal Photocoagulation - LPC
Non-damaging Laser Treatment in CSCR
Subthreshold Micropulse Laser (SML) Treatment
SML in Chronic CSCR (cCSCR)
SML in Acute CSCR (aCSCR)
Local Complications
SML Position in the Treatment of CSCR
Other Subthreshold Lasers
Photodynamic Therapy
PDT in the Treatment of Chronic CSCR
PDT in the Treatment of Acute CSCR
Technique
Complications
PDT Versus SML in the Treatment of CSCR
PDT Position in the Treatment of CSCR
Other Treatments in CSCR
Mineralocorticoid Inhibitors
Evolution of Treatment Strategies for CSCR
Timing of Treatment
Summary
References
7 Laser for Retinal Vascular Occlusions
Retinal Vein Occlusions
Introduction
Subtypes of Retinal Vein Occlusion
Branch Retinal Vein Occlusion
Central Retinal Vein Occlusion
Hemiretinal Vein Occlusion
Conventional Photocoagulation
Chorioretinal Anastomosis for Central Retinal Vein Occlusion
Short Pulse CW Laser (SRT, 2RT, PASCAL)
PASCAL
Selective Retina Therapy (SRT)
Nanosecond Laser (2RT)
Microsecond Pulsed Laser (MPL)
Retinal Artery Occlusion
Summary
References
8 Laser Treatment in Intraocular Tumors
Treatment of Circumscribed Choroidal Hemangioma
Treatment of Diffuse Choroidal Hemangioma
References
9 Laser Treatment in Rhegmatogenous Retinal Detachment
References
10 Laser Treatment of Vitreous Floaters
References
11 Ischemic Peripheral Retinopathies
Introduction
LPC in Specific Ischemic Retinopathies
Sickle cell retinopathy (SCR)
Idiopathic retinal vasculitis (IRV)
Inflammatory diseases with peripheral retinal vasculitis
Intraocular tuberculosis (IOTB)
Eales’ disease (ED)
Sarcoidosis
Systemic lupus erythematosus (SLE)
Antiphospholipid syndrome (APS)
Adamantiades-Behcet disease (ABD)
Ocular ischemic syndrome (OIS)
Carotid cavernous fistula (CCF)
Proliferative hypertension retinopathy (PHR)
Peripheral exudative hemorrhagic chorioretinopathy (PEHC)
Hiperviscosity syndromes (HVS)
Familial exudative vitreoretinopathy (FEVR)
Incontinentia pigmenti (IP)
Norrie disease (ND)
Talc retinopathy
Radiation retinopathy (RR)
References
12 Laser Treatment of Retinopathy of Prematurity
References
13 Laser Use for Hyaloidotomy
Subhyaloid Haemorrhage
Malignant Glaucoma
References
14 The Mechanism of Retinal Laser and Its End Result: Neuroprotecion
Current Thinking and Approaches to Neuroprotection
Eroom’s Law
Neuroprotection Candidates
Retinal Protection is Neuroprotection
Light, Laser, and the Retina
Laser-Induced Retinal Damage (LIRD): Sufficient, but Unnecessary
Role of the RPE in Retinal Neurodegenerations is Central
HSPs: Maintenance Versus Salvation
Sharp, Severe, but Sublethal
Implications from Pathoselectivity for Laser Treatment Optimization
Protein Misfolding: The Currency of Neurodegeneration
Time
Retinal Laser and Open Angle Glaucoma: A Model of Neuroprotection
Retinal Laser Treatment for OAG
ROAG (the Retinopathy of Open Angle Glaucoma)
Reset Non-fragility
References
15 Laser in Treatment of Retinal Artery Occlusions
Introduction
Therapeutic Approaches
Translumenal Nd: YAG Laser Embolysis
Case Presentation
Complications
Discussion
Conclusions
References
16 Laser Treatment of Submacular Hemorrhages
Introduction
Complications
Case Presentation
Discussion
Conclusions
References
17 Retinal Laser Telephotocoagulation and Teleeducation
The Concept of Telephotocoagulation with Navigated Laser
Teleeducation
References
18 Diabetes Mellitus Associated Progressive Neurovascular Retinal Injury
Introduction
The Normal Human Retinal Neurovascular Unit and the Lesions Associated with Diabetes
Pathologic Mechanisms Implicated in the Development of Retinal Lesions in Diabetic Patients
Microvascular Injury, Dysregulation, and Occlusion
Inflammatory Mechanisms Associated with the Neurovascular Injury
Treatment of Diabetic Retinopathy
The History of Treatment of Diabetic Retinopathy: Continuous Wave Laser Retinal Photocoagulation
Current Retinal Laser Therapy of Diabetic Retinopathy
Conclusion
References
19 The Future for Retinal Laser Treatment. Is There One?
Mechanism of Retinal Laser
References
