All Persistent Pupillary Membranes need not be treated - A case report

Persistent Pupillary Membrane is a common congenital anomaly which appears as a dense network of tissue across the pupil. It is usually asymptomatic, although blurring of vision can be seen in extensive conditions. This is a hospital based case study of an eleven year old girl with bilateral Persistent Pupillary Membrane since birth. The aim of the study is to establish that the treatment approach varies specific to the individual case and when asymptomatic, it can be safely left untreated as in the present study. Surgical Membranectomy, Pupilloplasty, Argon Laser Photocoagulation are the treatment options that can be considered in case of symptomatic conditions.

Effect of fundus retinal argon laser photocoagulation combined with calcium dobesilate in the treatment of diabetic retinopathy / 国际眼科杂志(Guoji Yanke Zazhi)

@#AIM: To explore the clinical value of fundus retinal argon laser photocoagulation combined with calcium dobesilate in the treatment of diabetic retinopathy(DR).<p>METHODS:A prospective study from August 2017 to August 2019 was conducted. Totally 182 patients(326 eyes)with DR were divided into two groups. The observation group received fundus retinal argon laser photocoagulation combined with calcium dobesilate, and the control group received fundus retinal argon laser photocoagulation. Flash electroretinography was performed before treatment and after treatment, and changes in a and b waves were recorded. Changes in the best corrected visual acuity(BCVA), retinal neovascularization fluorescein leakage area, central macular thickness(CMT)and retinal microcirculation parameters were detected. The absorption time of retinal edema, bleeding and exudation was recorded, and the incidence of postoperative complications was counted.<p>RESULTS: At 6mo after treatment, a-wave and b-wave amplitudes of the two groups were decreased(<i>P</i><0.001). The b-wave amplitude of observation group was larger than that of the control group(<i>P</i><0.05). There were no statistically significant differences in a-wave and b-wave peak time and amplitudes between the two groups(<i>P</i>>0.05). The BCVA of the two groups was increased, and the macular leakage area and CMT were reduced(<i>P</i><0.001). Compared with the control group, the BCVA of the observation group was higher, the macular leakage area and CMT were smaller, peak blood flow velocity and average blood flow velocity of the central retinal artery were higher, and the vascular resistance index and pulsatility index were lower(<i>P</i><0.001). The absorption time of edema, bleeding and exudation was shorter in observation group than in the control group(<i>P</i><0.001). There was no significant difference in the incidence of surgical complications between the two groups(<i>P</i>>0.05).<p>CONCLUSION: Fundus retinal argon laser photocoagulation combined with calcium dobesilate is superior to retinal photocoagulation alone in the treatment of DR. The former can promote the improvement of visual acuity, reduce fluorescein leakage, and promote the absorption of retinal edema, bleeding and exudation, which is conductive to improving retinal microcirculation and inhibiting neovascularization.

Subconjunctival bevacizumab and argon laser photocoagulation for preexisting neovascularization following deep lamellar anterior keratoplasty

We report a rare case of deep anterior lamellar keratoplasty (DALK) neovascularization managed with combination of subconjunctival bevacizumab and argon laser photocoagulation. A 24 year old male underwent Deep anterior lamellar keratoplasty for corneal stromal opacity following presumed viral keratitis. Deep corneal neovascularization was observed postoperatively which was successfully managed using a combination of subconjunctival bevacizumab and argon laser photocoagulation within one week of DALK. The neovascularization resolved by 3 months and at 2 years follow up, patient maintained good visual acuity of 6/12 Snellen's without recurrence of vascularization. A combination of bevacizumab and argon laser may be an effective approach to manage neovascularisation in the immediate postoperative phase (Post DALK) and improve graft survival.

Fotocoagulación con láser argón en el síndrome de transfusión feto-fetal

Se comunica el primer caso de cirugía fetal a nivel nacional en una gestante primigesta de 27 semanas con el diagnóstico de síndrome de transfusión feto-fetal, con categoría Quintero III, realizado en el Hospital Nacional EsSalud Huancayo Ramiro Priale Priale, utilizándose la técnica de fotocoagulación con láser de argón, por vía transcutánea. El resultado postoperatorio fue exitoso, con sobrevida en ambos fetos, los cuales nacieron vía cesárea luego de 25 días de la fotocoagulación, por presentar rotura prematura de membranas.

The first case of fetal surgery in Peru in a woman in her first 27 weeks pregnancy and diagnosis of category Quintero III feto-fetal transfusion syndrome is reported. It was performed at Hospital Nacional EsSalud Huancayo Ramiro Priale Priale using transcutaneous argon laser photocoagulation. Post operatory outcome was good and fetuses were born by cesarean section after 25 days from photocoagulation due to premature rupture of membranes.

Clinical Features of Conjunctival Nevi in Korean Patients

PURPOSE: To evaluate clinical features and therapeutic modality of conjunctival nevi in Korean patients. METHODS: A retrospective analysis was performed on 197 patients (75 males and 122 females) with nevi who were diagnosed by slit lamp examination from 1997 to 2008. RESULTS: Nevi occurred most commonly on bulbar conjunctiva (88%), followed by caruncle and plica semilunaris (7%). The nevi involved temporal (71%), nasal (21%), inferior (2.8%) and superior (0.7%) quadrants of the conjunctiva. The mean horizontal length was 4.3+/-2.0 mm and the mean vertical 4.45+/-2.2 mm. Thirty-five patients (7.8%) received no treatment. Excisional biopsy was performed in 38 patients (19.3%). Argon laser photoablation of conjunctiva nevi was performed in 124 patients (62.9%). CONCLUSIONS: The pattern of conjunctival nevi in Korean patients was similar to Caucasian patients. The biopsy was performed according to appropriate guidelines however, nevus which does not require a biopsy, could be treated by argon laser photoablation.

Photodynamic Therapy For Recurred Subfoveal Choroidal Neovascularization After Argon-Laser Photocoagulation

PURPOSE: To evaluate the effects of photodynamic therapy for subfoveal recurrences of juxtafoveal or extrafoveal choroidal neovascularization (CNV), previously treated with argon-laser photocoagulation. METHODS: Seven eyes, previously treated with argon-laser photocoagulation for juxtafoveal or extrafoveal choroidal neovascularization, received photodynamic therapy for subfoveal recurrence. Changes in visual acuity and fluorescein angiographic findings were analyzed. RESULTS: The average time of appearance of recurrent CNV after laser photocoagulation was 43.14+/-29.62 months (range, 2-77 months). After photodynamic therapy, fluorescein leakage and neovascular lesion size decreased in all patients on fluorescein angiography. Visual acuity was stabilized or improved in 5 of 7 eyes. CONCLUSIONS: Photodynamic therapy was effective in patients with subfoveal recurrences of juxtafoveal or extrafoveal choroidal neovascularization previously treated with argon-laser photocoagulation.

The Clinical Manifestations and Treatments of Parafoveal Telangiectasis

PURPOSE: To investigate the clinical manifestations and treatments of parafoveal telangiectasis. METHODS: Twenty-two eyes of fifteen patients diagnosed as parafoveal telangiectasis were selected who had visited Kong Eye Center from September 1999 to August 2003 complaining of decreasing visual acuity. Visual acuity was checked and fluorescein angiography and optical coherence tomography were done. Authors treated six eyes of six patients experienced decreasing visual acuity due to macular edema with argon laser photocoagulation and one eye of one patient accompanying with choroidal neovascularization with photodynamic therapy. RESULTS: Among fifteen patients, group 1 cases were eight (1B eight) and group 2 cases were seven by classification of Gass and Blodi. Visual acuity improved in two eyes of six eyes and maintained in four eyes of six eyes and optical coherence tomography showed decrease of macular edema in six eyes of six patients all after argon laser photocoagulation. Visual acuity improved and optical coherence tomography showed decrease of macular edema in one eye of one patient after photodynamic therapy. CONCLUSIONS: Group 1 cases were more than group 2 cases. Argon laser photocoagulation can be effectively used to treat decreasing visual acuity due to macular edema in parafoveal telangiectasis patients. Photodynamic therapy seems to be effective in parafoveal telangiectasis accompanied with choroidal neovascularization but we think that additional studies with more cases are needed.

The Morphological Changes of Muller Cell after Argon Laser Photocoagulation in Pigmented Rabbit

PURPOSE: Blood vessels within the retina are surrounded by Muller cells, and it is known that Muller cells may be related with the pathogenesis of diabetic retinopathy based on this histologic structure. Argon laser photocoagulation is routinely performed in the treatment of diabetic retinopathy by inhibiting neovascularization and edema, but its mechanism remains unclear. Muller cell changes were demonstrated utilizing carbonic anhydrase immunohistochemical staining to know a relation between argon laser photocoagulation and the effect of Muller cells in the rabbit retina. METHODS: Author used 16 rabbit retinas which were obtained from 8 rabbits. Exposure time and spot size were kept 0.15 second and 500 microgram. 150~350 mW of power intensity was needed to produce moderate degree coagulation in rabbit retina. RESULTS: We observed retina and its histological changes at 1 week, 2 weeks, 3 weeks and 4 weeks after photocoagulation by using carbonic anhydrase staining. The differences in the morphological changes in Muller cells and retina layers were observed between moderate and severe degree coagulation. With severe degree coagulation, the loss of all the retinal layers was observed. On the other hand, with moderate degree coagulation, proliferated pigment epithelial cells and chorioretinal adhesion were observed with loss of photoreceptor and outer nuclear layer. Muller cells were observed by carbonic anhydrase staining with proliferated Muller cells with increased nuclei and proliferated process. CONCLUSIONS: These findings suggest that Muller cells might be important in the scar formation by argon laser photocoagulation and that the proliferaration of Muller cells play a certain role in the therapeutic mechanism.

Treatment of Acute Retinopathy of Prematurity with Argon Indirect Laser Ophthalmoscope 2nd Report

PURPOSE: It is to report the efficacy and safety of an argon laser photocoagulation which was the treatment modality for retinopathy of prematurity. METHODS: From March 1996 to December 1999, on 69 prethreshold retinopathy of prematurity, they were series of observations following periods of two to five days, one week, two weeks, four weeks, three months and one year time respectively. RESULTS: We noticed the regressions in 84 prethreshold retinopathy of prematurity cases as well. CONCLUSIONS: The report emphasized the advantages of the argon laser photocoagulation which reduce the risk from a general anesthesia by applying a topical anesthesia, and the safety of using laser technique of convenience to apply and minimize the tissue damages of the lesions. It also described the preferable consequent results following the early treatment with divided applications on the prethreshold cases.

A Case of Cyclodialysis Cleft Treated with Argon Laser Photocoagulation

Cyclodialysis with hypotony is defined as a rare disorder that meridional ciliary muscle is disinserted from its attachment at the scleral spur due to trauma or intraocula surgery such as extracapsular cataract extraction with or without intraocular lens implantation, iridectomy, and etc. Its managements include conservative therapy with cycloplegics, and surgical treatment such as argon laser photocoagulation, cyclopexy, and diathermy. The authors diagnosed cyclodialysis cleft by observing clinical features and finding of the cleft in the anterior chamber angle with gonioscopy. The cyclodialysis cleft with hypotony has been treated with argon laser photocoagulation into the cleft area.

Treatment of Acute Retinopathy of Prematurity with Argon Indirect Laser Opthalmoscope

Twenty two eyes of twelve infants with threshold or prethreshold retinopathy of prematurity were treated by using the Argon laser through an indirect ophthalmoscopic delivery system. Eyes that had persistent plus disease were retreated to the missed areas. Mean follow-up period was 8.1 months. 20 of 22 eyes were regressed and all of prethreshold ROP were regressed. Our results suggest that argon laser photocoagulation is as effective as cryotherapy in the treatment of ROP and excellent results can be obtained by treating prethreshold zone I or posterior zone II ROP. And laser treatment is better tolerated by infant, accurate, easy, less destructive and not requires general anesthesia.

Distribution of Glycoconjugates During Wound Healing After Argon Laser Photocoagulation in Pigmented Rabbit Retina

Lectin is a non-immunological glycoprotein and binds specifically to carbohydrate terminals in tissue. Lectin histochemistry using 10 different biotinylated lectins was performed to investigate the effects on thirty-two pigmented rabbit retinas during wound healing. The results are as follows: 1) In normal retina. a) WGA, RCA I, and LCA were bound to the internal limiting membrane. b) WGA, RCA I, LCA, and PNA were bound to the photoreceptor layer. c) WGA, RCA I, LCA, SJA, ConA and BSL I were bound to the basal side of retinal pigment epithelium. d) PNA was bound to cone cell only. e) SBA, DBA, and UEA I didn't bind to any layers of retina. 2) In photocoagulated wound. One day after photocoagulation WGA, LCA and RCA I began to show increased reaction. At 3 and 5 days these lectins sustained reactivity. At 7 days increased reactivity began to decrease or disappear from wound. Macrophages had positive reaction to BSL I, WGA, LCA, and RCA I. In conclusion these results indicate that a-mannose, a glucose, a, beta-galactose, N-acetylglucosamine, and N-acetylneuramic acid are present in glycoconjugates of normal rabbit neural retina. It seems that some glycoconjugates may be related to vitreoretinal, retinal and chorioretinal adhesion in normnal retinal, and after argon laser photocoagulation. WGA-binding, LCA-binding and RCA I-binding glycoconjugates may play a part in cell adhesion during early wound healing.

Treatment of corneal neovascularization with argon laser

Corneal neovascularization, which is associated with complications in corneal diseases, can cause lipid deposit, decreasing vision, and graft rejection after penetrating keratoplasty (PKP). Corneal laser photocoagulation using an argon laser or yellow dye laser for ablation of corneal neovascularization has been described. We performed corneal argon laser photocoagulation (CALP) in two male patients with corneal neovascularization after herpetic keratitis. One PKP was performed after CALP and restored good vision with no rejection of the graft during an 8 month follow-up period. In the other case we observed visual improvement and no recurrence of corneal neovascularization after CALP.

A Clinical Study on Therapeutic Effect of the Argon Laser Photocoagulation on Central Serous Chorioretinopathy

In selected cases of central serous chorioretinopathy the pigment epithelial defect can be sealed with laser photocoagulation. The authors analyzed the effectiveness of laser photocoagulation on visual improvement and duration of the disease in laser treated group, as compared to untreated group, which represented na tural course of the disease. A verage healing time was 5.2 weeks in treated group and 13.9 weeks in untreated group, which revealed statistically significant difference between two groups(p<0.01). No difference was noted in visual outcome between two groups. The initial visual acuity was influenced by the type of dye leaking, the distance of leaking point from center of fovea and the size of sensory retinal detachment in fluorescein angiography. But the final visual acuity was only ihfluenced by the size of sensory retinal detachment. The number and location of leaking point did not influence the initial and final visual acuity in both treated and untreated group.