Retinal Oxygenation and Laser Treatment in Patients With Diabetic Retinopathy

Stefánsson, Einar; Machemer, Robert; Juan, Eugene de; McCuen, Brooks W.; Peterson, John C.

doi:10.1016/s0002-9394(14)75750-2

Cited by 142 publications

(76 citation statements)

References 3 publications

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“…As widespread capillary occlusion leads to insufficient oxygen supply to the peripheral neuroretina, which then releases angiogenic factors in an inappropriate attempt to revascularize, ablation of ischaeic tissue may allow sufficient perfusion to the remaining tissue to remove the stimulus for angiogenesis and cause new vessels to regress [136]. An alternative hypothesis is that PRP, besides destroying the highly oxygen-requiring photoreceptor-pigment epithelium complex, could let oxygen diffuse from the choroid to the inner retina [137]. Indeed, the diameter of retinal vessels is reduced after PRP, possibly as a consequence of increased oxygen availability.…”

Section: Laser Treatment Of Proliferative Retinopathymentioning

confidence: 99%

Diabetic retinopathy

2002

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Abstract. Easy observation of the fundus oculi makes retinopathy the most frequently reported chronic complication of diabetes and, consequently, the one we know best in terms of epidemiology and natural history. Achieving near-normal levels of blood glucose and blood pressure provides empirical though powerful tools for clinicians to delay the onset and progression of diabetic retinopathy. Even when these measures have failed and retinopathy becomes sight-threatening, laser photocoagulation has proven remarkably effective. Nonetheless, retinopathy remains a leading cause of blindness and there is little evidence that diabetes-related visual loss is decreasing in industrialized countries. This may result from the mixed blessing of prolonged survival of patients who had become diabetic when metabolic control was pursued less fastidiously than today. Screening for sight-threatening retinopathy is the most cost-effective medical procedure known and should help optimise the use of diagnostic and therapeutic resources, but its widest deployment still meets with inertia and lack of interest within most health care systems. Improving clinical skills and technology, however, allow us to take a more optimistic look at the future, as pathogenesis-targeted forms of treatment are being developed and tested through appropriately powered clinical trials. [Diabetologia (2002[Diabetologia ( ) 45:1617[Diabetologia ( -1634

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Section: Laser Treatment Of Proliferative Retinopathymentioning

confidence: 99%

Diabetic retinopathy

2002

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“…where, C Hb total is the total concentration of Hb, e oxy , and e de-oxy are the extinction coefficients of HbO 2 and deoxygenated Hb, respectively, corrected for convolution with the spectral response of the LCTF; d is the vessel diameter, cOS is the calculated OS, Z is the effective optical path-length contribution, 38 and a is a scaling constant. The function accounts for the backscatter by blood cells.…”

Section: Oxygen Saturation Calculationmentioning

confidence: 99%

Spectral imaging of the retina

Mordant

Alabboud

Muyo

et al. 2011

Eye

107

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Introduction The work described here involved the use of a modified fundus camera to obtain sequential hyperspectral images of the retina in 14 normal volunteers and in 1 illustrative patient with a retinal vascular occlusion. Methods The paper describes analysis techniques, which allow oximetry within retinal vessels; these results are presented as retinal oximetry maps. Results Using spectral images, with wavelengths between 556 and 650 nm, the mean oxygen saturation (OS) value in temporal retinal arterioles in normal volunteers was 104.3 ( ± 16.7), and in normal temporal retinal venules was 34.8 (±17.8). These values are comparable to those quoted in the literature, although, the venular saturations are slightly lower than those values found by other authors; explanations are offered for these differences. Discussion The described imaging and analysis techniques produce a clinically useful map of retinal oximetric values. The results from normal volunteers and from one illustrative patient are presented. Further developments, including the recent development of a 'snapshot' spectral camera, promises enhanced non-invasive retinal vessel oximetry mapping.

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“…It has been suggested that retinal ischaemia stimulate retinal neovascularization (Wise 1956), and that proliferations are preceded by capillary non-perfusion (Patz 1980). Experimental animal models as well as human studies have documented increased oxygen tension close to the retina following panretinal photocoagulation (Novack et al 1990;Stefansson et al 1992). From other studies, it is known that diabetic patients have detectably higher oxygen tension in relation to retinal areas, which previously have received photocoagulation compared to areas, which have not received this treatment (Stefansson et al 1992).…”

Section: Effect Of Specific Treatmentmentioning

confidence: 99%

“…Experimental animal models as well as human studies have documented increased oxygen tension close to the retina following panretinal photocoagulation (Novack et al 1990;Stefansson et al 1992). From other studies, it is known that diabetic patients have detectably higher oxygen tension in relation to retinal areas, which previously have received photocoagulation compared to areas, which have not received this treatment (Stefansson et al 1992). Structural studies of retinal areas, which previously have received photocoagulation seem to indicate regeneration of the pigment epithelium following this treatment, whereas other parts of the retina including the light receptors will not regenerate (Novack et al 1990).…”

Section: Effect Of Specific Treatmentmentioning

confidence: 99%

Ocular fluorophotometry in human subjects and in swine – with particular reference to long‐term pharmacokinetics

Knudsen

2002

Acta Ophthalmologica Scandinavica

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Retinal Oxygenation and Laser Treatment in Patients With Diabetic Retinopathy

Cited by 142 publications

References 3 publications

Diabetic retinopathy

Diabetic retinopathy

Spectral imaging of the retina

Ocular fluorophotometry in human subjects and in swine – with particular reference to long‐term pharmacokinetics

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