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Sonntag SR, Hamann M, Seifert E, Grisanti S, Brinkmann R, Miura Y. Detection sensitivity of fluorescence lifetime imaging ophthalmoscopy for laser-induced selective damage of retinal pigment epithelium. Graefes Arch Clin Exp Ophthalmol 2024:10.1007/s00417-024-06449-2. [PMID: 38587656 DOI: 10.1007/s00417-024-06449-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2023] [Revised: 03/05/2024] [Accepted: 03/08/2024] [Indexed: 04/09/2024] Open
Abstract
PURPOSE To investigate the sensitivity of fluorescence lifetime imaging ophthalmoscopy (FLIO) to detect retinal laser spots by comparative analysis with other imaging modalities. METHODS A diode laser with a wavelength of 514 nm was applied with pulse durations of 5.2, 12, 20, and 50 µs. The laser pulse energy was increased so that the visibility of the laser spot by slit-lamp fundus examination (SL) under the irradiator's observation covers from the subvisible to visible range immediately after irradiation. The irradiated areas were then examined by fundus color photography (FC), optical coherence tomography (OCT), fundus autofluorescence (AF), FLIO, and fluorescein angiography (FA). The visibility of a total of over 2200 laser spots was evaluated by two independent researchers, and effective dose (ED) 50 laser pulse energy values were calculated for each imaging modality and compared. RESULTS Among examined modalities, FA showed the lowest mean of ED50 energy value and SL the highest, that is, they had the highest and lowest sensitivity to detect retinal pigment epithalium (RPE)-selective laser spots, respectively. FLIO also detected spots significantly more sensitively than SL at most laser pulse durations and was not significantly inferior to FA. AF was also often more sensitive than SL, but the difference was slightly less significant than FLIO. CONCLUSION Considering its high sensitivity in detecting laser spots and previously reported potential of indicating local wound healing and metabolic changes around laser spots, FLIO may be useful as a non-invasive monitoring tool during and after minimally invasive retinal laser treatment.
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Affiliation(s)
- Svenja Rebecca Sonntag
- Department of Ophthalmology, University Hospital Schleswig-Holstein, Campus Lübeck, Lübeck, Germany
| | - Maximilian Hamann
- Department of Ophthalmology, University Hospital Schleswig-Holstein, Campus Lübeck, Lübeck, Germany
- Department of Ophthalmology, Hannover Medical School, Hannover, Germany
| | | | - Salvatore Grisanti
- Department of Ophthalmology, University Hospital Schleswig-Holstein, Campus Lübeck, Lübeck, Germany
| | - Ralf Brinkmann
- Medical Laser Center Lübeck, Lübeck, Germany
- Institute of Biomedical Optics, University of Lübeck, Lübeck, Germany
| | - Yoko Miura
- Department of Ophthalmology, University Hospital Schleswig-Holstein, Campus Lübeck, Lübeck, Germany.
- Medical Laser Center Lübeck, Lübeck, Germany.
- Institute of Biomedical Optics, University of Lübeck, Lübeck, Germany.
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Deladurantaye P, Méthot S, Mermut O, Galarneau P, Rochette PJ. Potential of sub-microsecond laser pulse shaping for controlling microcavitation in selective retinal therapies. BIOMEDICAL OPTICS EXPRESS 2020; 11:109-132. [PMID: 32010504 PMCID: PMC6968749 DOI: 10.1364/boe.11.000109] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/28/2019] [Revised: 11/08/2019] [Accepted: 11/25/2019] [Indexed: 06/10/2023]
Abstract
Pilot results showing the potential of sub-microsecond laser pulse shaping to optimize thermomechanical confinement in laser-tissue interactions involving microcavitation are presented. Model samples based on aqueous suspensions of retinal melanosomes and eumelanin particles were irradiated at 532 nm with nanosecond laser pulses and picosecond laser pulse trains having differing shapes and durations. The cavitation threshold radiant exposure and the bubble lifetime above the threshold were measured using a pump-probe setup and sub-nanosecond time-resolved imaging. Both quantities were found to strongly depend on the pulse format. These results suggest that sub-microsecond laser pulse shaping could be exploited to optimize precision and control in numerous applications of laser-directed microcavitation, including selective retinal laser treatments.
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Affiliation(s)
- Pascal Deladurantaye
- Axe Médecine Régénératrice, Centre de recherche du CHU de Québec- Université Laval, Hôpital du Saint-Sacrement, Québec, Canada
- Centre de recherche en Organogénèse Expérimentale de l’Université Laval/LOEX, Université Laval, Québec, Canada
- Institut National d’Optique (INO), Québec, Canada
| | - Sébastien Méthot
- Axe Médecine Régénératrice, Centre de recherche du CHU de Québec- Université Laval, Hôpital du Saint-Sacrement, Québec, Canada
- Centre de recherche en Organogénèse Expérimentale de l’Université Laval/LOEX, Université Laval, Québec, Canada
| | - Ozzy Mermut
- Institut National d’Optique (INO), Québec, Canada
- Department of Physics and Astronomy, York University, Ontario, M3J 1P3, Canada
| | | | - Patrick J Rochette
- Axe Médecine Régénératrice, Centre de recherche du CHU de Québec- Université Laval, Hôpital du Saint-Sacrement, Québec, Canada
- Centre de recherche en Organogénèse Expérimentale de l’Université Laval/LOEX, Université Laval, Québec, Canada
- Département d’ophtalmologie, Faculté de Médecine, Université Laval, Québec, Canada
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Han JW, Choi J, Kim YS, Kim J, Brinkmann R, Lyu J, Park TK. Comparison of the neuroinflammatory responses to selective retina therapy and continuous-wave laser photocoagulation in mouse eyes. Graefes Arch Clin Exp Ophthalmol 2018; 256:341-353. [PMID: 29322247 DOI: 10.1007/s00417-017-3883-7] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2017] [Revised: 11/02/2017] [Accepted: 12/20/2017] [Indexed: 01/12/2023] Open
Abstract
PURPOSE This study investigated microglia and inflammatory cell responses after selective retina therapy (SRT) with microsecond-pulsed laser in comparison to continuous-wave laser photocoagulation (cwPC). METHODS Healthy C57BL/6 J mice were treated with either a train of short pulses (SRT; 527-nm, Q-switched, 1.7-μs pulse) or a conventional thermal continuous-wave (532-nm, 100-ms pulse duration) laser. The mice were sacrificed and their eyes were enucleated 1, 3, 7, and 14 days after both laser treatments. Pattern of cell death on retinal section was evaluated by TUNEL assay, and the distribution of activated inflammatory cells and glial cells were observed under immunohistochemistry. Consecutive changes for the expression of cytokines such as IL-1β, TNF-α, and TGF-β were also examined using immunohistochemistry, and compared among each period after quantification by Western blotting. RESULTS The numbers of TUNEL-positive cells in the retinal pigment epithelium (RPE) layer did not differ in SRT and cwPC lesions, but TUNEL-positive cells in neural retinas were significantly less on SRT. Vague glial cell activation was observed in SRT-treated lesions. The population of inflammatory cells was also significantly decreased after SRT, and the cells were located in the RPE layer and subretinal space. Proinflammatory cytokines, including IL-1β and TNF-α, showed significantly lower levels after SRT; conversely, the level of TGF-β was similar to the cwPC-treated lesion. CONCLUSIONS SRT resulted in selective RPE damage without collateral thermal injury to the neural retina, and apparently produced negligible glial activation. In addition, SRT showed a markedly less inflammatory response than cwPC, which may have important therapeutic implications for several macular diseases.
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Affiliation(s)
- Jung Woo Han
- Department of Ophthalmology, College of Medicine, Soonchunhyang University, Bucheon, South Korea
| | - Juhye Choi
- Department of Medical Science, Konyang University, 158 Gwanjeodong-ro, Seo-gu, Daejeon, 320-832, Republic of Korea
| | - Young Shin Kim
- Department of Ophthalmology, College of Medicine, Soonchunhyang University, Bucheon, South Korea
| | - Jina Kim
- Department of Ophthalmology, College of Medicine, Soonchunhyang University, Bucheon, South Korea
| | - Ralf Brinkmann
- Institute of Biomedical Optics, University of Lübeck and Medizinisches Laserzentrum Lübeck GmbH, Lübeck, Germany
| | - Jungmook Lyu
- Department of Medical Science, Konyang University, 158 Gwanjeodong-ro, Seo-gu, Daejeon, 320-832, Republic of Korea.
| | - Tae Kwann Park
- Department of Ophthalmology, College of Medicine, Soonchunhyang University, Bucheon, South Korea. .,Laboratory for Translational Research on Retinal Macular Degeneration, College of Medicine, Soonchunhyang University, Bucheon, South Korea. .,Department of Ophthalmology, Soonchunhyang University College of Medicine, Soonchunhyang University Bucheon Hospital, #170 Jomaruro, Wonmi-gu, Bucheon-si, Gyeonggi-do, 420-767, South Korea.
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Chidlow G, Plunkett M, Casson RJ, Wood JP. Investigations into localized re-treatment of the retina with a 3-nanosecond laser. Lasers Surg Med 2016; 48:602-15. [DOI: 10.1002/lsm.22506] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/01/2016] [Indexed: 12/15/2022]
Affiliation(s)
- Glyn Chidlow
- Ophthalmic Research Laboratories; Hanson Institute Centre for Neurological Diseases; Frome Rd Adelaide SA 5000 Australia
- Discipline of Ophthalmology and Visual Sciences; University of Adelaide; Frome Rd Adelaide SA 5005 Australia
| | - Malcolm Plunkett
- Ophthalmic Research Laboratories; Hanson Institute Centre for Neurological Diseases; Frome Rd Adelaide SA 5000 Australia
| | - Robert J. Casson
- Ophthalmic Research Laboratories; Hanson Institute Centre for Neurological Diseases; Frome Rd Adelaide SA 5000 Australia
- Discipline of Ophthalmology and Visual Sciences; University of Adelaide; Frome Rd Adelaide SA 5005 Australia
| | - John P.M. Wood
- Ophthalmic Research Laboratories; Hanson Institute Centre for Neurological Diseases; Frome Rd Adelaide SA 5000 Australia
- Discipline of Ophthalmology and Visual Sciences; University of Adelaide; Frome Rd Adelaide SA 5005 Australia
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Chehade L, Chidlow G, Wood J, Casson RJ. Short-pulse duration retinal lasers: a review. Clin Exp Ophthalmol 2016; 44:714-721. [PMID: 27059681 DOI: 10.1111/ceo.12754] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2016] [Revised: 03/22/2016] [Accepted: 03/29/2016] [Indexed: 01/31/2023]
Abstract
The development of lasers for biological use was an important medical advance in the 20th century with numerous evidence-based therapeutic applications to retinal disease, including capillary leakage at the macula. Although the role of photocoagulative laser in the treatment of macular oedema has diminished, there is evidence for a modified role in clinical management, particularly for extrafoveal leakage. Additionally, it may reduce the frequency of required intravitreal injections and assist in visual stabilization when used as an adjunct. The tissue destructive effect of photocoagulative lasers has motivated the development of safer macular lasers and the search for novel therapeutic applications, including treatment of drusen and regeneration of dysfunctional retinal pigment epithelium.
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Affiliation(s)
- Luke Chehade
- South Australian Institute of Ophthalmology, Hanson Institute, Australia.,University of Adelaide, Adelaide, South Australia, Australia
| | - Glyn Chidlow
- South Australian Institute of Ophthalmology, Hanson Institute, Australia.,University of Adelaide, Adelaide, South Australia, Australia
| | - John Wood
- South Australian Institute of Ophthalmology, Hanson Institute, Australia.,University of Adelaide, Adelaide, South Australia, Australia
| | - Robert J Casson
- South Australian Institute of Ophthalmology, Hanson Institute, Australia.,University of Adelaide, Adelaide, South Australia, Australia
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A Comparative Study of Retinal Function in Rabbits after Panretinal Selective Retina Therapy versus Conventional Panretinal Photocoagulation. J Ophthalmol 2015; 2015:247259. [PMID: 26525905 PMCID: PMC4615217 DOI: 10.1155/2015/247259] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2015] [Revised: 09/07/2015] [Accepted: 09/09/2015] [Indexed: 01/21/2023] Open
Abstract
Purpose. This study evaluates functional changes in electroretinographic findings after selective retina therapy (SRT) compared to panretinal photocoagulation (PRP) in rabbits. Methods. The right eyes of 12 Chinchilla rabbits received 200 laser treatment spots. The right eyes of six rabbits received SRT (SRT group), whereas the other six animals were treated using PRP on the right eye (PRP group). The eyes were investigated using full-field ERG 1 hour and 3 weeks after treatment. Histologic exam to assess the tissue response of lasers was performed on 3 weeks. Results. No significant changes in the mean ROD or CR b-wave amplitudes of the SRT lesions were evident, compared to baseline, 1 h after laser treatment (p = 0.372 and 0.278, resp.). In addition, the OPs and 30 Hz flickers of the SRT lesions were not significantly altered (p = 0.17 and 0.243, resp.). At 3 weeks, similar results were found. Comparing the two groups, the ROD b-wave amplitude was reduced in the PRP and SRT groups to 60.04 ± 4.2% and 92.32 ± 6.43% of baseline (p < 0.001). Histologically, there was no visible photoreceptor alterations on week 3. Conclusions. SRT in rabbit eyes induced less functional loss than PRP in both rod-mediated retinal function and cone-mediated retinal function. In addition, SRT irradiated eyes had no functional loss compared to its control.
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Park YG, Seifert E, Roh YJ, Theisen-Kunde D, Kang S, Brinkmann R. Tissue response of selective retina therapy by means of a feedback-controlled energy ramping mode. Clin Exp Ophthalmol 2014; 42:846-55. [PMID: 24698550 DOI: 10.1111/ceo.12342] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2013] [Accepted: 03/27/2014] [Indexed: 11/27/2022]
Abstract
BACKGROUND The purpose of the study was to evaluate the safety and selectivity of the retinal pigment epithelium lesions by using automatic energy ramping and dosimetry technique for selective retina therapy and to investigate the healing response. METHODS Ten eyes of Chinchilla Bastard rabbits were treated with an automatic dosage controlled selective retina therapy laser (frequency doubled Q-switched Nd:YLF, wavelength: 527 nm, pulse duration: 1.7 μs, repetition rate: 100 Hz, pulse energy: linear increasing from pulse to pulse up to shut down - maximal 110 μJ, max. number of pulses in a burst: 30, retinal spot diameter: 133 μm). After treatment, fundus photography, optical coherence tomography and fluorescein angiography were performed at three time points from 1 h to 3 weeks. Histological analysis was performed. RESULTS A total of 381 selective retina therapy laser spots were tested (range 13-104 μJ).Typical fundus photographs obtained at 1 h after irradiation showed that 379 out of 381 lesions produced by selective retina therapy were not visible ophthalmoscopically and the lesions could be detected by angiography only. Optical coherence tomography images revealed that the structure of photoreceptors was preserved, but a disrupted retinal pigment epithelium layer was observed as was expected. By 3 weeks, histology showed selective retinal pigment epithelium damage without any effect on the inner retina and focal proliferation of the retinal pigment epithelium layer. CONCLUSIONS Automatically controlled selective retina therapy is a significant improvement in this innovative treatment. It could be demonstrated that the non-contact, reflectometric technique with a controlled pulse energy ramp is safe and selective.
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Affiliation(s)
- Young-Gun Park
- Department of Ophthalmology, Yeouido St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
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Abstract
PURPOSE To prospectively investigate the safety and efficacy of a novel frequency-doubled nanosecond-pulsed laser with discontinuous beam energy distribution (2RT, Ellex) for the treatment of diabetic macular edema. METHODS Twenty-three consecutive patients (38 eyes) with newly diagnosed diabetic macular edema were recruited and assessed with logarithm of the minimum angle of resolution best-corrected visual acuity, central macular thickness measured with optical coherence tomography (OCT/scanning laser ophthalmoscope, OPKO/OTI), microperimetry, fundus photography, and fundus fluorescein angiography. Macular grid treatments were performed with 2RT laser system by 1 operator. Patients were examined with logarithm of the minimum angle of resolution best-corrected visual acuity, central macular thickness, microperimetry, and fundus photography at 3 weeks and 6 weeks and 3 months and 6 months. Fundus fluorescein angiography was repeated at 3 months and 6 months. RESULTS Six months postoperatively, 17 patients (28 eyes) completed the study. No complications were identified after 2RT therapy. Intraoperative retinal discoloration was observed in 2 cases, fully resolved at 3 months with no permanent anatomical or functional changes. Mean logarithm of the minimum angle of resolution visual acuity improved from 20/44 at baseline to 20/27 at 6 months. The change in best-corrected visual acuity was significant (P = 0.0190). Central macular thickness in the central 1-mm subfield, retinal exudates and vascular leakage decreased in the majority of patients at 6 months (46, 41, and 55%, respectively), although the change from baseline was not statistically significant. Microperimetry confirmed photoreceptor integrity and showed a trend of improvement that correlated with decreased central macular thickness. CONCLUSION For the first time, we achieved a beneficial effect on diabetic macular edema without the side effects of conventional laser therapy. The efficacy of this system in comparison with standard argon laser photocoagulation and in the treatment of other conditions affecting the retinal pigment epithelium needs further investigation.
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Wood JP, Plunkett M, Previn V, Chidlow G, Casson RJ. Nanosecond pulse lasers for retinal applications. Lasers Surg Med 2011; 43:499-510. [DOI: 10.1002/lsm.21087] [Citation(s) in RCA: 40] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
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Emerson R, Town G. Hair removal with a novel, low fluence, home-use intense pulsed light device. J COSMET LASER THER 2009; 11:98-105. [DOI: 10.1080/14764170902792199] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Lach E. Reduction of subcutaneous fat and improvement in cellulite appearance by dual‐wavelength, low‐level laser energy combined with vacuum and massage. J COSMET LASER THER 2009; 10:202-9. [DOI: 10.1080/14764170802516680] [Citation(s) in RCA: 33] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Cho BJ, Kim TW, Woo SJ, Chung H, Heo JW. Short-term Clinical Outcome of Patterned Scanning Laser Photocoagulation With Short Exposure Time in Diabetic Retinopathy. JOURNAL OF THE KOREAN OPHTHALMOLOGICAL SOCIETY 2009. [DOI: 10.3341/jkos.2009.50.3.376] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Affiliation(s)
- Bum Joo Cho
- Department of Ophthalmology, Seoul National University College of Medicine, Seoul, Korea
- Seoul Artificial Eye Center, Seoul National University Hospital Clinical Research Institute, Seoul, Korea
| | - Tae Wan Kim
- Department of Ophthalmology, Seoul National University College of Medicine, Seoul, Korea
- Department of Ophthalmology, Seoul Metropolitan Boramae Hospital, Seoul, Korea
| | - Se Joon Woo
- Department of Ophthalmology, Seoul National University College of Medicine, Seoul, Korea
- Department of Ophthalmology, Seoul National University Bundang Hospital, Seongnam, Korea
| | - Hum Chung
- Department of Ophthalmology, Seoul National University College of Medicine, Seoul, Korea
- Seoul Artificial Eye Center, Seoul National University Hospital Clinical Research Institute, Seoul, Korea
| | - Jang Won Heo
- Department of Ophthalmology, Seoul National University College of Medicine, Seoul, Korea
- Seoul Artificial Eye Center, Seoul National University Hospital Clinical Research Institute, Seoul, Korea
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Framme C, Walter A, Prahs P, Theisen-Kunde D, Brinkmann R. Comparison of threshold irradiances and online dosimetry for selective retina treatment (SRT) in patients treated with 200 nanoseconds and 1.7 microseconds laser pulses. Lasers Surg Med 2008; 40:616-24. [DOI: 10.1002/lsm.20685] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
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