PURPOSE: To compare the pain scale and time necessary for panretinal photocoagulation (PRP) between Navilas(R) (OD-OS, Teltow, Germany) and conventional laser in diabetic retinopathy. METHODS: Fifteen patients who required PRP for diabetic retinopathy were enrolled in the present study. PRP was performed using Navilas(R) (5 x 5 array patterned system) in the superior, nasal and inferior areas, and using conventional laser at the temporal area 1 week later. Total time of laser application and number of laser shots were counted for calculating required time per 100 spots of each laser system. Immediately after the laser photocoagulation, patients were asked to quantify their pain on a visual analog pain scale (0 = no pain; 10 = worst pain). RESULTS: PRP using Navilas(R) required shorter time per 100 laser spots (27.7 sec vs. 102.0 sec, p < 0.001) and subjects had lower treatment-related pain than with the conventional laser system (3.3 vs. 6.9, p < 0.001). CONCLUSIONS: PRP using Navilas(R) can be considered as an efficient method for improving patient and operator's comfort with faster laser application and lower treatment-related pain.
Diabetic Retinopathy* ; Humans ; Laser Therapy* ; Light Coagulation* ; Pain Measurement

To evaluate the clinical aspects of central serous chorioretinopathy, the patients were analysized and divided into three groups: group I) initial visitants; group II) those who undertook fluorescein angiography; and group III) those who had been followed over 3 months. The overall frequency of this disease was 0.69%. In group I, of 262 patients, 76.5% was male, 85.5% in the forth and fifth decades and 7.7% bilateral. In group II, of 130 eyes (120 patients), only neurosensory retina was detached in 121 eyes. Of which 106 eyes (87.6%) which had ink blot leakage and 95 eyes (78.5%) had one leakage point. In 96 eyes (79.3%), leakage point located within one disc from the fovea. In group III, of 105 eyes (95 patients), initial visual acuity was better than 0.7 in 58 eyes (55.2%) and worse than 0.3 in 14 eyes (13.3%). Final visual acuity was better than 0.7 in 94 eyes (89.5%) and worse than 0.3 in 4 eyes (4.0%). In 34 eyes which were laser-treated, duration of recovery (10.8 vs 6.4 weeks; P=0.016) and frequency of recurrence (42.3 vs 17.6%; P=0.013) decreased to a statistically significantly compared with 71 conservatively treated eyes. Central serous chorioretinopathy has the high possibility of recurrence and therefore should be followed up periodically for possible need for laser photocoagulation.
Central Serous Chorioretinopathy ; Fluorescein Angiography ; Humans ; Ink ; Laser Therapy ; Light Coagulation ; Male ; Recurrence ; Retina ; Visual Acuity

BACKGROUND: The current modality of choice for the treatment of Port-wine stains (PWS) is laser photocoagulation. Laser therapy for the treatment of PWS, especially with a pulsed dye laser (PDL), has been proven safe and effective; however, because penetration of the PDL is too shallow for an effective ablation of the blebs, treatment of blebbed PWS, using PDL, may be insufficient. OBJECTIVE: We demonstrated the clinical efficacy of a 1,064 nm long pulsed Nd:YAG laser with contact cooling device for blebbed PWS. METHODS: Twenty one patients with blebbed PWS (Fitzpatrick skin types II-V) underwent a treatment, using a 1,064 nm long pulsed Nd:YAG laser with a contact cooling device at 8-week intervals. Treatments were done using 5~6 mm spot sizes at 20~30 ms and 95~170 J/cm2. Laser parameters were adjusted in order to meet the needs of each individual patient's lesions. RESULTS: All subjects tolerated the treatments well, and showed clinical improvement from blebs. Of the 21 patients, 18 of them experienced either moderate or excellent response. CONCLUSION: Use of a 1,064 nm long pulsed Nd:YAG laser results in a greater depth of vascular coagulation. A 1,064 nm long pulsed Nd:YAG laser with contact cooling device may be regarded as a promising therapeutic option for the treatment of blebbed PWS.
Blister ; Humans ; Laser Therapy ; Lasers, Dye ; Light Coagulation ; Port-Wine Stain ; Skin

Rabbit eyes were irradiated with a neodymium-yttrium-aluminum-garnet (Nd-YAG) laser and the changes in prostaglandin E and protein levels in the aqueous humor were measured. Intraocular pressure and pupil diameter were also determined in the same rabbits. Prostaglandin E and protein in the aqueous humor were increased depending upon the number of laser lesions. The increase in intraorular pressure and the decrease in pupil diameter occurred at similar dosages of laser irradiation. The response of the iris to the photodisruption was rapid. Changes in prostaglandin and protein contents and pupil diameter were already prominent 15 min after laser irradiation. Indomethacin pretreatment abolished most of these responses, suggesting that acute reactions following photodisruption were largely dependent on prostaglandin synthesis in iris tissue
Administration, Topical ; Animals ; Aqueous Humor/*analysis ; Female ; Indomethacin/*pharmacology ; Iris/*surgery ; Laser Therapy ; *Light Coagulation ; Male ; Prostaglandins E/*analysis ; Rabbits

PURPOSE: To evaluate the visual prognosis of retinal arterial macroaneurysm with various treatment. METHODS: We did retrospective study in 16 patients(16 eyes) of retinal arterial macroaneurysm diagnosed at our hospital from March 1996 to January 2003. RESULTS: The range of patient's age was from 26 to 92 year-old, and 10 patients were female and 6 patients were male. In 6 eyes without treatment, spontaneous absorption of hemorrhage or edema occurred in 4 eyes. In 2 eyes with preretinal hemorrhage involving the macular area, vision was improved 2 lines or more as hemorrhage was subsided. Two eyes with Nd: YAG laser photodisruption obtained visual improvement of 4 lines or more. In 2 eyes misdiagnosed as CNV, argon laser photocoagulation was performed. In 6 eyes treated surgically with tPA injection or pars plana vitrectomy, 5 eyes showed visual improvement of 4 lines or more. CONCLUSIONS: Laser therapy or vitrectomy seems to be an effective method for the treatment of retinal arterial macroaneurysm involving the macular area.
Absorption ; Argon ; Edema ; Female ; Hemorrhage ; Humans ; Laser Therapy ; Lasers, Solid-State ; Light Coagulation ; Male ; Prognosis ; Retinaldehyde* ; Retrospective Studies ; Vitrectomy

Diabetic retinopathy(DR) is the leading cause of new onset blindness among working-aged groups in industrialized countries, and its incidence is expected to increase along with the rising incidence of diabetes mellitus. Primary interventions such as strict glycemic control, tight blood pressure regulation, and lipid-lowering therapy can significantly reduce the risk of DR occurrence and progression. Currently, laser photocoagulation is the mainstay of treatment of proliferative DR and some cases of diabetic macular edema (DME). However, a considerable number of DR patients still suffer from severe visual impairment in spite of the application of laser photocoagulation and even of pars plana vitrectomy. Considering the limitations of current DR treatments, ongoing efforts have been devoted to the development of new therapeutic strategies, and it has become necessary to focus on pharmacologic treatment. Since inflammation has been identified as playing a substantial role in the pathogenesis of DR, corticosteroids with an anti-inflammatory effect can be included in the treatment of DR, though this may cause cataract and intraocular pressure elevation. The recent discovery of inhibitors of vascular endothelial growth factor is a revolutionary event in the management of DR, specifically DME. Some new agents aiming at the process of angiogenesis and increased vascular permeability are still under investigation, offering hope for a more effective future treatment of this sight-threatening disease. This paper reviews the current state of knowledge of the clinical presentation, preventive management, and clinical therapeutic strategies of DR and DME.
Adrenal Cortex Hormones ; Blindness ; Blood Pressure ; Capillary Permeability ; Cataract ; Developed Countries ; Diabetes Mellitus ; Diabetic Retinopathy* ; Hope ; Humans ; Incidence ; Inflammation ; Intraocular Pressure ; Laser Coagulation ; Light Coagulation ; Macular Edema ; Vascular Endothelial Growth Factor A ; Vascular Endothelial Growth Factors ; Vision Disorders ; Vitrectomy

Diabetic macular edema is one of the most common causes of visual acuity impairment in adults. Various treatment modalities are currently used. They include laser therapy, intravitreal or periocular injection of steroid, intravitreal injection of anti-vascular endothelial growth factor, and pars plana vitrectomy. Introduction of newer therapeutic agents, such as ranibizumab and aflibercept has changed the paradigm of treatment approaches for diabetic macular edema. However, traditional treatment methods, such as laser photocoagulation and vitrectomy, are still being used effectively in certain situations. Each treatment modality has its own unique mode of action, and has advantages and disadvantages at the same time. Given multiple mechanisms are involved in the development of diabetic macular edema, a combination treatment approach is often employed rather than using only one of the treatment modalities. In this review, treatment outcomes of each approach are summarized and combination approaches are discussed.
Adult ; Bevacizumab ; Dexamethasone ; Endothelial Growth Factors ; Humans ; Injections, Intraocular ; Intravitreal Injections ; Laser Therapy ; Light Coagulation ; Macular Edema* ; Ranibizumab ; Visual Acuity ; Vitrectomy

PURPOSE: To report a case of hypotony maculopathy caused by traumatic cyclodialysis and treated by vitrectomy combined with gas tamponade and cryotherapy. METHODS: A 35-year-old man with hypotony maculopathy caused by traumatic cyclodialysis was unsuccessfully treated with conservative medical therapy, laser photocoagulation, and direct cyclopexy. The intraocular pressure (IOP) was 2 mm Hg and the vision was counting finger with chorioretinal folds. Vitrectomy combined with gas tamponade and cryotherapy was performed without lens surgery 5 months after trauma. RESULTS: After vitrectomy, fundus photograph and optical coherence tomography revealed complete loss of preoperative chorioretinal folds. The visual acuity improved to 0.3 and IOP was maintained within a normal range during the 24 month follow-up. CONCLUSIONS: This case shows that vitrectomy combined with gas tamponade and cryotherapy is effective for the treatment of traumatic cyclodialysis with persistent hypotony, probably without lens surgery.
Adult ; Cryotherapy* ; Fingers ; Follow-Up Studies ; Humans ; Intraocular Pressure ; Laser Therapy ; Light Coagulation ; Reference Values ; Tomography, Optical Coherence ; Visual Acuity ; Vitrectomy*

Little is known about the natural history and management of choroidal neovascularization (CNV) which developed as a complication of laser photocoagulation for central serous chorioretinopathy (CSC). We experienced two patients with CNV which developed after laser treatment for CSC. Submacular membranectomy was performed on both cases after the confirmation of subretinal CNV with optical coherence tomography. One patient received photodynamic therapy for recurrent CNV. The vision of both patients has been improved over 6 months of follow up. These cases suggest that active intervention, including submacular surgery, improves the visual prognosis of this condition.
Adult ; Choroid Diseases/*surgery ; Choroidal Neovascularization/etiology/*surgery ; Diagnostic Techniques, Ophthalmological ; Female ; Human ; Interferometry ; Laser Coagulation/*adverse effects ; Light ; Male ; Retinal Diseases/*surgery ; Tomography ; Treatment Outcome ; Visual Acuity

In twins, growth restriction is found in up to 25%, and intertwin birth weight discordance of more than 20% is frequently recorded. The discordance is usually measured as intrapair weight difference, expressed as a percentage of the larger twin's weight. Monochorionic twins represent a high-risk group for adverse pregnancy outcome. Although unequal placental sharing may lead to selective intrauterine growth restriction of one twin, unequal blood flow by placental may cause twin-to-twin transfusion syndrome (TTTS). TTTS will develop in around 15% of monochorionic twins and constitutes one of the major causes of fetal growth discordance in monochorionic twins. The two main available treatments for TTTS are laser therapy and amnioreduction. A recent randomized controlled trial provided strong evidence suggesting that laser therapy is superior to amnioreduction in term of survival and neurologic outcomes diagnosed before 26 weeks of the severe cases of TTTS. Laser photocoagulation is an anatomical correctional treatment that aims at interrupting the vascular anastomoses responsible for the hemodynamic decompensation, whereas amnioreduction is a palliative treatment that reduces the effects of the increased amniotic fluid pressure. So we must have alternative strategy to predict early sign and symptoms of TTTS and make the available referral network to management of these discordant twins.
Amniotic Fluid ; Birth Weight ; Female ; Fetal Development ; Fetofetal Transfusion ; Hemodynamics ; Humans ; Laser Therapy ; Light Coagulation ; Palliative Care ; Pregnancy ; Pregnancy Outcome ; Pregnancy, Twin ; Referral and Consultation