ABSTRACT
Medicinal lasers are a standard source of light to produce retinal tissue photocoagulation to treat retinovascular disease. The Diabetic Retinopathy Study and the Early Treatment Diabetic Retinopathy Study were large randomized clinical trials that have shown beneficial effect of retinal laser photocoagulation in diabetic retinopathy and have dictated the standard of care for decades. However, current treatment protocols undergo modifications. Types of lasers used in treatment of retinal diseases include argon, diode, dye and multicolor lasers, micropulse lasers and lasers for photodynamic therapy. Delivery systems include contact lens slit-lamp laser delivery, indirect ophthalmocope based laser photocoagulation and camera based navigated retinal photocoagulation with retinal eye-tracking. Selective targeted photocoagulation could be a future alternative to panretinal photocoagulation
Subject(s)
Retina , Laser Coagulation , Diabetic Retinopathy , Retinal DiseasesABSTRACT
Optical coherence tomography [OCT] is now an integral part of management for numerous retinal diseases for diagnosis, treatment planning and follow up. OCT interpretation must involve the understanding of the associated artifacts. These artifacts can mislead physicians to wrong diagnosis or inappropriate management. This review article discusses the various types of artifacts in OCT scans obtained from various devices in various retinal diseases. This article would help to improve the understanding about the various artifacts and their clinical importance
ABSTRACT
Adaptive optics [AO] is a technology used to improve the performance of optical systems by reducing the effect of wave front distortions. Retinal imaging using AO aims to compensate for higher order aberrations originating from the cornea and the lens by using deformable mirror. The main application of AO retinal imaging has been to assess photoreceptor cell density, spacing, and mosaic regularity in normal and diseased eyes. Apart from photoreceptors, the retinal pigment epithelium, retinal nerve fiber layer, retinal vessel wall and lamina cribrosa can also be visualized with AO technology. Recent interest in AO technology in eye research has resulted in growing number of reports and publications utilizing this technology in both animals and humans. With the availability of first commercially available instruments we are making transformation of AO technology from a research tool to diagnostic instrument. The current challenges include imaging eyes with less than perfect optical media, formation of normative databases for acquired images such as cone mosaics, and the cost of the technology. The opportunities for AO will include more detailed diagnosis with description of some new findings in retinal diseases and glaucoma as well as expansion of AO into clinical trials which has already started
ABSTRACT
Being the most vascular tissue of the eye, importance of the choroid has been very well established in various retinal and chorio-retinal diseases. Understanding of the choroidal structures has improved significantly since the evolution of enhanced depth imaging. Quantitative assessment of choroidal measurements has been found to be reproducible using different devices. This review article describes factors affecting choroidal thickness and choroidal changes in several diseases and reports its clinical importance. Evaluation of choroid would provide insight into the pathogenesis, treatment planning and follow up in chorioretinal diseases
ABSTRACT
To evaluate success with intravitreal injection of ocriplasmin in releasing symptomatic vitreomacular traction [VMT]. A retrospective review of consecutive series of patients in a single vitreoretinal practice. Patients with symptomatic distortion and loss of vision secondary to VMT were included in the study. Patients received a single injection of ocriplasmin [JETREA] and were followed-up after 1 month with optical coherence tomography. Eight patients [8 eyes] were included [2 males and 6 females] in the study. Five of 8 eyes [62.5%] experienced complete release of the VMT; one of 8 eyes [12.5%] had partial release of VMT and two of 8 eyes [25%] did not have release of VMT. The two patients with no release of their VMT had the same vision. Of the 5 patients with complete release of VMT, 3 patients had a one line worsening of their vision, 1 had a 4 line improvement of vision, and 1 stayed the same. The patient with only partial release of their VMT had a 1 line worsening of vision. Intravitreal ocriplasmin is a promising treatment option for vitreomacular traction syndrome in symptomatic patients
ABSTRACT
The laser photocoagulation is now treatment of choice for various retinovascular disorders. Conventional slit-lamp based laser delivery systems have many limitations including, questionable accuracy, need of contact lens with local anesthesia, and inadvertent damage to fovea. Navigated laser system, a fundus camera based laser delivery system with computer based laser planning and laser treatment without contact lens achieves improved patient compliance, improved accuracy, and treatment ease for the physician, efficient panretinal photocoagulation pattern laser, excellent documentation, and advanced laser training. This article compares navigated laser systems with available conventional and PASCAL laser systems based on the literature and personal experience of the authors