Selective Retina Therapy

Považay, Boris; Brinkmann, Ralf; Stoller, Markus; Kessler, Ralf

doi:10.1007/978-3-030-16638-0_11

Cited by 8 publications

(8 citation statements)

References 81 publications

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“…Furthermore, the effect causes local reduction of the autofluorescence signal as well, that was particularly shown for short therapy laser pulses before [36]. Due to the orders of magnitude shorter laser pulses that deliver lower energy doses, a negligible thermal effect was induced as opposed to the known thermal photocoagulation therapies [42]. High peak powers reaching 10 11 W/cm 2 irradiance rather introduced local plasma mediated ablation [43] on the sites with high melanin content.…”

Section: Discussionmentioning

confidence: 99%

“…The main changes are seen through the local shifts in τm, presented in histograms (Fig. 5, 4th column)and through the partial disappearance of the RPE region, the effect known for a successful selective retinal therapy (SRT) that can be a consequence of either the cell death [36] or the local laser ablation [37].…”

Section: Quantification Of Two-photon Diagnostics and Therapy Of Mopa Gs Fiber Laser On Ex-vivo Retinal Tissuementioning

confidence: 99%

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Two-photon retinal theranostics by adaptive compact laser source

et al. 2020

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To avoid a devastating effect of eye vision impairment on the information flow from the eye to our brain, enormous effort is being put during the last decades into the development of more sensitive diagnostics and more efficient therapies of retinal tissue. While morphology can be impressively imaged by Optical Coherence Tomography, molecular-associated pathology information can be provided almost exclusively by auto-fluorescence-based methods. Among the latter, the recently developed Fluorescence lifetime imaging ophthalmoscopy (FLIO) has the potential to provide both structural information and interacting pictures at the same time. The requirements for FLIO laser sources are almost orthogonal to the laser sources used in phototherapy that is expected to follow-up the FLIO diagnostics. To make theranostics more effective and cheaper, the complete system would need to couple at least the modalities of low power high repetition rate FLIO and precision high-pulse energy adjustable repetition rate phototherapy. In addition, the intermediate power high repetition rate for two-photon excitation would also be desired to increase the depth resolution. In our work, compact fiber-laser-based on high-speed gain-switched laser diode has been shown to achieve adaptable / independently tunable repetition rate and energy per pulse allowing coupled fluorescence lifetime diagnostics via two-photon excitation and phototherapy via laser-induced photodisruption on a local molecular environment in a complex ex-vivo retinal tissue.

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Section: Discussionmentioning

confidence: 99%

Section: Quantification Of Two-photon Diagnostics and Therapy Of Mopa Gs Fiber Laser On Ex-vivo Retinal Tissuementioning

confidence: 99%

Two-photon retinal theranostics by adaptive compact laser source

et al. 2020

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“…26,27 Very recently, new compact laser sources with high continuous wave power >15 W and variable pulse duration from 2 μs to 50 μs were investigated for retinal therapies. 28 With these new high-power laser sources, for the first time, subvisible effects with repetitive micropulses, 3,[29][30][31] pure thermal tissue damage as in LPC, and MBF-related thermomechanical effects as in SRT might be accessed with just one laser system, only by adjusting the pulse duration and pulse repetition rate appropriately. However, so far, only few studies have investigated the transition regime from thermomechanical to thermal effects in the 2-to 50-μs pulse regime, accessible with this high power.…”

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confidence: 99%

Investigations on Retinal Pigment Epithelial Damage at Laser Irradiation in the Lower Microsecond Time Regime

Seifert

Sonntag

Kleingarn

et al. 2021

Invest. Ophthalmol. Vis. Sci.

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Purpose New lasers with a continuous wave power exceeding 15 W are currently investigated for retinal therapies, promising highly localized effects at and close to the Retinal Pigment Epithelium (RPE). The goal of this work is to evaluate mechanisms and thresholds for RPE cell damage by means of pulse durations up to 50 µs. Methods A diode laser with a wavelength of 514 nm, a power of 15 W, and adjustable pulse durations between 2 µs and 50 µs was used. Porcine RPE-choroidal explants (ex vivo) and chinchilla bastard rabbits (in vivo) were irradiated to determine threshold radiant exposures for RPE damage by calcein vitality staining and fluorescence angiography, respectively. Thresholds for microbubble formation (MBF) were evaluated by time-resolved optoacoustics. Exemplary histologies support the findings. Results is significantly higher than at pulse durations ≥ 5 µs ( P < 0.05) ex vivo, while at 2 µs, no statistically significant difference was found. The ratios between and increase with pulse duration from 1.07 to 1.48 ex vivo and 1.1 to 1.6 in vivo, for 5.2 and 50 µs. Conclusions Cellular damage with and without MBF related disintegration are both present and very likely to play a role for pulse durations ≥ 5 µs. With the lower µs pulses, selective RPE disruption might be possible, while higher values allow achieving spatially limited thermal effects without MBF. However, both modi require a very accurate real-time dosing control in order to avoid extended retinal disintegration in this power range.

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“…This is thought to spare the surrounding retina and induce selective changes in RPE function that yield a therapeutic effect. 44 SRT has undergone limited study in the treatment of CSCR with positive visual and anatomic results in retrospective and small prospective trials for acute and chronic CSCR. [45][46][47] Further study is needed to compare the efficacy of SRT versus more established treatments like PDT.…”

Section: Non-pdt Laser Therapymentioning

confidence: 99%

Update on the Management of Central Serous Chorioretinopathy

Bordbar,

Skrehot,

Weng

2023

International Ophthalmology Clinics

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Selective Retina Therapy

Cited by 8 publications

References 81 publications

Two-photon retinal theranostics by adaptive compact laser source

Two-photon retinal theranostics by adaptive compact laser source

Investigations on Retinal Pigment Epithelial Damage at Laser Irradiation in the Lower Microsecond Time Regime

Update on the Management of Central Serous Chorioretinopathy

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