Koinzer Stefan, Elsner Hanno, Klatt Carsten, Pörksen Erk, Brinkmann Ralf, Birngruber Reginald, Roider Johann
Department of Ophthalmology, University Hospital of Schleswig-Holstein, Campus Kiel, Hegewischstr.2, 24105 Kiel, Germany.
Graefes Arch Clin Exp Ophthalmol. 2008 Oct;246(10):1373-8. doi: 10.1007/s00417-008-0860-1. Epub 2008 Jun 11.
Shallow subfoveal fluid accumulation after successful surgery for retinal detachment can be the reason for compromised visual acuity. To date, therapeutical options to tackle this problem have not been established. Selective retina therapy (SRT) is a new laser technology that uses a train of mus-laser pulses to selectively damage retinal pigment epithelial (RPE) cells while sparing retinal structures.
We treated three patients with chronic subfoveal fluid accumulation after retinal detachment surgery. The median period between retinal surgery and SRT treatment was 7 months. For SRT, we used a prototype frequency-doubled, Q-switched Nd:YLF laser (lambda = 527 nm). Each laser exposition contained 30 pulses (t = 1,7 micros, 100 Hz, E = 100-400 microJ). Two of the three patients were treated subfoveally. OCT III (optical coherence tomography) examinations were performed to evaluate changes in subretinal fluid accumulation.
In all three patients, we observed complete resolution of subfoveal fluid within 1-5 months. Follow-up has been 16 months to 2 years. Visual acuity improved in all patients. In one patient, cystoid macular edema developed 3 months after treatment. Additional SRT treatments were not necessary.
SRT is a safe treatment. Visual acuity improved after SRT, even in subfoveal irradiations. SRT is an option to support subretinal fluid reabsorption. In this situation where no other therapeutical options are established, SRT may be a beneficial treatment for chronic subfoveal fluid accumulation after retinal detachment surgery.
视网膜脱离手术成功后，黄斑中心凹下浅液体积聚可能是视力受损的原因。迄今为止，尚未确立解决这一问题的治疗方案。选择性视网膜治疗（SRT）是一种新的激光技术，它使用一系列微秒级激光脉冲来选择性地损伤视网膜色素上皮（RPE）细胞，同时保留视网膜结构。
我们治疗了3例视网膜脱离手术后黄斑中心凹下慢性液体积聚的患者。视网膜手术与SRT治疗之间的中位时间为7个月。对于SRT，我们使用了一台倍频调Q Nd:YLF激光原型机（波长=527nm）。每次激光照射包含30个脉冲（脉宽=1.7微秒，频率=100Hz，能量=100-400微焦）。3例患者中有2例接受了黄斑中心凹下治疗。进行光学相干断层扫描（OCT III）检查以评估视网膜下液体积聚的变化。
在所有3例患者中，我们观察到1-5个月内黄斑中心凹下液体完全消退。随访时间为16个月至2年。所有患者的视力均有改善。1例患者在治疗后3个月出现黄斑囊样水肿。无需额外的SRT治疗。
SRT是一种安全的治疗方法。即使是黄斑中心凹下照射，SRT后视力也有所改善。SRT是支持视网膜下液吸收的一种选择。在尚无其他治疗方案的情况下，SRT可能是视网膜脱离手术后慢性黄斑中心凹下液体积聚的一种有益治疗方法。
