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有机染料与激光在人眼底的临床病理研究

Clinicopathologic study of organic dye. Laser in the human fundus.

作者信息

Brooks H L, Eagle R C, Schroeder R P, Annesley W H, Shields J A, Augsburger J J

机构信息

Retina Service, Wills Eye Hospital, Philadelphia.

出版信息

Ophthalmology. 1989 Jun;96(6):822-34. doi: 10.1016/s0161-6420(89)32827-2.

Abstract

One day before enucleation for choroidal melanoma, four patients consented to experimental laser photocoagulation for the purpose of comparing the histopathologic appearance of acute chorioretinal lesions produced by various dye laser wavelengths with krypton red and argon green laser controls. Three patients had simulated "light" and "heavy" treatment of an extrafoveal choroidal neovascular membrane (CNVM) with wavelengths 577 nm (yellow), 595 nm (orange), and 600 nm (orange). One patient had simulated panretinal photocoagulation (PRP) with four different dye laser wavelengths. Extrafoveal "light" treatment with the three dye wavelengths and both controls spared the inner retina and produced similar effects in the outer retina, pigment epithelium, and choriocapillaris. Choroidal penetration was deepest with the longer wavelengths (590-647 nm) in both "light" and "heavy" treatment groups. "Heavy" treatment gave varying degrees of full-thickness retinal uptake for all dye and both control wavelengths. Both ends of the orange spectrum (590-600 nm) produced the most severe inner retinal uptake. Panretinal photocoagulation produced similar full-thickness retinal uptake for all four dye wavelengths tested. These results indicate that caution should be used when treating "heavily" with 590 and 600 nm in the extrafoveal area.

摘要

在因脉络膜黑色素瘤进行眼球摘除术的前一天,四名患者同意接受实验性激光光凝治疗,目的是将各种染料激光波长产生的急性脉络膜视网膜病变的组织病理学表现与氪红激光和氩绿激光对照组进行比较。三名患者用577纳米(黄色)、595纳米(橙色)和600纳米(橙色)波长对黄斑外脉络膜新生血管膜(CNVM)进行了模拟“轻度”和“重度”治疗。一名患者用四种不同的染料激光波长进行了模拟全视网膜光凝(PRP)。用三种染料波长和两个对照组进行的黄斑外“轻度”治疗均未累及视网膜内层,在外层视网膜、色素上皮和脉络膜毛细血管中产生了相似的效果。在“轻度”和“重度”治疗组中,波长较长(590 - 647纳米)时脉络膜穿透最深。对于所有染料和两个对照波长,“重度”治疗均导致不同程度的视网膜全层摄取。橙色光谱的两端(590 - 600纳米)导致视网膜内层摄取最为严重。对于所测试的所有四种染料波长,全视网膜光凝均产生了相似的视网膜全层摄取。这些结果表明,在黄斑外区域用590和600纳米进行“重度”治疗时应谨慎。

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