Therapeutic Effects of Ruby Laser Photocoagulation on Retinal Diseases

ABSTRACT

I. Central Serous Chorioretinopathies One hundred and nine patients with central serous retinopathy were an a lysed after treatment with AO Laser Photocoagulator. The patients in this study were mainly male (87%) between the ages of 30 and 40 years (81.5%). Involvement was exclusively unilateral (98.1 %), and fluorescein fundus angiography revealed leaking points in almost all cases (98.1%). Majority of patients (67.4%) recovered normal vision with one or two sittings of photocoagulation, each sitting composed of 6 to 8 energy pulses producing grade I lesion. During the course of this study normal vision is gained in 80.2% of patients. With the development of fluorescein fundus angiography the lesion of central serous retinopathy were found to be choroidal abnormalities associated serous leakage across Bruch's membrane. Burn is made by the light energy delivered to pigment epithlium. The burn results, through normal healing processes, in a scar, which seals off the communication across Bruch's membrane. This phenomenon constructs the basis of treatment of central serous retinopathy with photocoagulation. II. Diabetic Retinopathies Diabetic retinopathy is rapidly becoming the prominent cause of blindness in the world. The striking change of retinopathy is in the venous side of retinal capillaries and their altered function leads to exudation, hemorrhage, formation of new vessels, and fibrosis over the retinal plane or into vitreous, resuJting ultimately into blindness. Of the 34 patients treated with AO Ruby Photocoagulator at Han Yang Uni. Hos., the response of the patients in pre-proliferative stage was excellent, all of them recovering vision above 0.8. The patients in proliferative stage, however, responded poorly to photocoagulation. It is learned in this study that the optimal time of photocoagulation is in the pre-proliferative stage. The photocoagulation of retinitis proliferans has some effect only in arresting or delaying the progress of retinal changes. III. Focal Choroiditis Nonsuppurative intracular inflammation is caused by various etiology. Scrutinization such as serologic and skin test or x-ray finding is important for the diagnosis of uveitis but not so significant as the definitive clinical characteristics of specific forms of ocular inflammation. Focal choroiditis, sized less than 1/4 disk diameter, was coagulated with ruby laser. Four out of 6 patients recovered good vision, the lesion being replaced by a scar. The remaining two patients did not visit the hospital after one session of photocoagulation. It is emphasized by the author that the focal choroiditis is excellent indication to the laser photocoagulation. IV. Eales' Disease Eales' disease is considered to be due to hypersensitivity to mostly tuberculo-antigen, clinically characterized by retinal perivenous exudate, neovascularization and vitreous hemorrhage. A boy has recovered his normal vision after 18 sessions of ruby laser photocoagulation. There have been no benificent effects where photocoagulation was discontinued after two or three sittings.