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Life
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Basics and Clinics of Retinal Laser Therapy
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Basics and Clinics of Retinal Laser Therapy

A special issue of Life (ISSN 2075-1729). This special issue belongs to the section "Medical Research".

Deadline for manuscript submissions: closed (30 March 2023) | Viewed by 6908

Special Issue Editors

Dr. Yoko Miura

E-Mail Website1 Website2
Guest Editor
1. Institute of Biomedical Optics, University of Lübeck, 23562 Lübeck, Germany
2. Department of Ophthalmology, University Medical Center Schleswig-Holstein, Campus Lübeck, 23538 Lübeck, Germany
3. Medical Laser Center Lübeck, 23562 Lübeck, Germany
Interests: retinal laser treatment; laser–tissue interaction; cell metabolism; oxidative stress; retinal cell/organ culture; optical coherence tomography; fluorescence lifetime imaging
Dr. Jan Tode

E-Mail Website1 Website2
Guest Editor
Department of Ophthalmology, Hannover Medical School, 30625 Hannover, Germany
Interests: age-related-macular degeneration; retina; retinal laser therapy; translational research in animal models; inflammation and retina; ocular response to retinal laser therapies; fibrosis; microRNA

Special Issue Information

Dear Colleagues,

Laser therapy has become an indispensable part of medical treatment along with drug therapy in the treatment of retinal disorders. Besides the commonly applied laser coagulation for the treatment of ischemic and proliferative retinal diseases, various minimally invasive laser techniques have been developed, allowing laser treatment within the macular region, where central vision is located. These novel laser therapies, also called sub-threshold, stimulate or selectively disrupt retinal pigment epithelium cells (RPE), leaving neuroretina undamaged. Dosimetry and controlling systems even increase the safety of these systems. The development of such technologies is underway and may broaden the range of treatment options and enable more individualized treatment.

Unlike drug therapy, laser therapy treats the affected area locally and has minimal side effects. In order to take full advantage of this, it is important to understand the local tissue response to laser irradiation. There are various mechanisms of actions, including thermal photocoagulation, sublethal hyperthermia, or mechanical destruction. Therefore, it is essential to improve our understanding on the laser–tissue interaction of each type of laser in detail. This may help us to reach more desired treatment effects. Advancing laser treatment modi to new and effective concepts other than the above mentioned could help to reach even more diseases. There is still a long way to go before a broad application of these novel laser therapies and clinical trials is essential.

The purpose of this Special Issue is to deepen our knowledge about retinal laser therapies and to promote their further development in both research and clinical practice. We would like to feature your precious reports on basic and clinical research on various retinal laser treatments, from interdisciplinary fields, as well as any kind of clinical results.

Dr. Yoko Miura
Dr. Jan Tode
Guest Editors

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Life is an international peer-reviewed open access monthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2600 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • retina
  • laser
  • retinal pigment epithelium
  • macular disease
  • dosimetry
  • subthreshold laser therapy
  • minimally-invasive retinal laser therapy

Published Papers (4 papers)

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Research

13 pages, 2146 KiB  
Article
Quantitative Evaluation of Fundus Autofluorescence in Laser Photocoagulation Scars for Diabetic Retinopathy: Conventional vs. Short-Pulse Laser
by Toshiya Kimura, Shuntaro Ogura, Tsutomu Yasukawa and Miho Nozaki
Life 2023, 13(9), 1901; https://doi.org/10.3390/life13091901 - 12 Sep 2023
Viewed by 940
Abstract
Short-pulse laser is popular for its advantages like less pain. However, its effectiveness is still debated. The aim of this study was to compare fundus autofluorescence (FAF) luminosity changes of laser photocoagulation scars between the conventional laser (0.2 s) and the short-pulse laser [...] Read more.
Short-pulse laser is popular for its advantages like less pain. However, its effectiveness is still debated. The aim of this study was to compare fundus autofluorescence (FAF) luminosity changes of laser photocoagulation scars between the conventional laser (0.2 s) and the short-pulse laser (0.02 s) for diabetic retinopathy. Conventional and short-pulse laser photocoagulations were performed in six and seven eyes, respectively. FAF images were captured at 1, 3, 6, 12, and 18 months after the treatments. To evaluate FAF, individual gray-scale values of the laser scars adjacent to the retinal arcade vessels were recorded; then, the mean gray values of the scars were divided by the luminosity of arcade vein. The average luminosity ratio of laser scars at 1, 3, 6, 12, and 18 months were 1.51 ± 0.17, 1.26 ± 0.07, 1.21 ± 0.03, 0.95 ± 0.11, and 0.89 ± 0.05 with conventional laser and 1.91 ± 0.13, 1.50 ± 0.15, 1.26 ± 0.08, 1.18 ± 0.06, and 0.97 ± 0.04 with short-pulse laser, respectively. Findings suggest the short-pulse laser displayed delayed hypoautofluorescence progression. This implies potential postponement in post-irradiation atrophic changes, as well as metabolic amelioration delay in the ischemic retina, when compared to conventional laser treatment. Full article
(This article belongs to the Special Issue Basics and Clinics of Retinal Laser Therapy)
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22 pages, 4957 KiB  
Article
Investigation of the Influence of Pulse Duration and Application Mode on Microsecond Laser Microsurgery of the Retinal Pigment Epithelium
by Christian Burri, Simon Salzmann, Mylène Amstutz, Leonie Hoffmann, Boris Považay, Christoph Meier and Martin Frenz
Life 2023, 13(6), 1314; https://doi.org/10.3390/life13061314 - 2 Jun 2023
Cited by 1 | Viewed by 1459
Abstract
Optical microsurgery confined to the retinal pigment epithelium (RPE) requires locally optimized laser parameters and reliable real-time feedback dosimetry (RFD) to prevent unwanted neuroretinal overexposure. This study aimed to compare pulses of different durations and application modes (single, ramp, burst). Moreover, optical coherence [...] Read more.
Optical microsurgery confined to the retinal pigment epithelium (RPE) requires locally optimized laser parameters and reliable real-time feedback dosimetry (RFD) to prevent unwanted neuroretinal overexposure. This study aimed to compare pulses of different durations and application modes (single, ramp, burst). Moreover, optical coherence tomography (OCT)-based RFD was investigated in an ex vivo experiment, utilizing nine porcine eyes that were exposed to laser pulses of 8, 12, 16 and 20 µs duration (wavelength: 532 nm, exposure area: 90 × 90 µm2, radiant exposure: 247 to 1975 mJ/µm2). Simultaneously, time-resolved OCT M-scans were recorded (central wavelength: 870 nm, scan rate: 85 kHz) for RFD. Post irradiation, retinal changes were assessed with color fundus photography (CFP) and cross-sectional OCT B-scans. RPE cell damage was quantified via fluorescence-based cell viability assay and compared to the OCT dosimetry feedback. Our experiments indicate cumulative RPE damage for pulse bursts of 16 µs and 20 µs, whereas no cumulative effects were found for pulse durations of 8 µs and 12 µs applied in ramp mode. According to statistical analysis, OCT-RFD correctly detected RPE cell damage with 96% sensitivity and 97% specificity using pulses of 8 µs duration in ramp mode. Full article
(This article belongs to the Special Issue Basics and Clinics of Retinal Laser Therapy)
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10 pages, 8304 KiB  
Article
High-Precision Optical Coherence Tomography Navigated Laser Retinopexy for Retinal Breaks
by Simon Salzmann, Philip Wakili, Sami Al-Nawaiseh, Boris Považay, Christoph Meier and Christian Burri
Life 2023, 13(5), 1145; https://doi.org/10.3390/life13051145 - 9 May 2023
Viewed by 1566
Abstract
The prevalent cause of retinal detachment is a full-thickness retinal break and the ingress of fluid into the subretinal space. To prevent progression of the detachment, laser photocoagulation (LPC) lesions are placed around the break in clinical practice to seal the tissue. Unlike [...] Read more.
The prevalent cause of retinal detachment is a full-thickness retinal break and the ingress of fluid into the subretinal space. To prevent progression of the detachment, laser photocoagulation (LPC) lesions are placed around the break in clinical practice to seal the tissue. Unlike the usual application under indirect ophthalmoscopy, we developed a semi-automatic treatment planning software based on a sequence of optical coherence tomography (OCT) scans to perform navigated LPC treatment. The depth information allows demarcation of the border where the neurosensory retina is still attached to the retinal pigment epithelium (RPE), which is critical for prevention of detachment progression. To evaluate the method, artificially provoked retinal breaks were treated in seven ex-vivo porcine eyes. Treatment outcome was assessed by fundus photography and OCT imaging. The automatically applied lesions surrounding each detachment (4.4–39.6 mm2) could be identified as highly scattering coagulation regions in color fundus photography and OCT. Between the planned and applied pattern, a mean offset of 68 µm (SD ± 16.5 µm) and a mean lesion spacing error of 5 µm (SD ± 10 µm) was achieved. The results demonstrate the potential of navigated OCT-guided laser retinopexy to improve overall treatment accuracy, efficiency, and safety. Full article
(This article belongs to the Special Issue Basics and Clinics of Retinal Laser Therapy)
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15 pages, 4049 KiB  
Article
Temperature Increase and Damage Extent at Retinal Pigment Epithelium Compared between Continuous Wave and Micropulse Laser Application
by Yoko Miura, Keiji Inagaki, Alessa Hutfilz, Eric Seifert, Benedikt Schmarbeck, Akira Murakami, Kishiko Ohkoshi and Ralf Brinkmann
Life 2022, 12(9), 1313; https://doi.org/10.3390/life12091313 - 26 Aug 2022
Cited by 5 | Viewed by 1890
Abstract
Continuous wave (CW) and microsecond pulse (MP) laser irradiations were compared regarding cell damage and laser-induced temperature rise at retinal pigment epithelium (RPE). The RPE of porcine RPE-choroid-sclera explants was irradiated with a 577 nm laser in CW or MP mode (5% or [...] Read more.
Continuous wave (CW) and microsecond pulse (MP) laser irradiations were compared regarding cell damage and laser-induced temperature rise at retinal pigment epithelium (RPE). The RPE of porcine RPE-choroid-sclera explants was irradiated with a 577 nm laser in CW or MP mode (5% or 15% duty cycle (DC)) for 20 ms or 200 ms at an average laser power of 20–90 mW. Cell viability was investigated with calcein-AM staining. Optoacoustic (OA) technique was employed for temperature measurement during irradiation. For 200 ms irradiation, the dead cell area (DCA) increased linearly (≈1600 µm2/mW) up to the average power of 40 mW for all modes without significant difference. From 50 mW, the increase of DCA of MP-5% significantly dropped to 610 µm2/mW (p < 0.05), likely due to the detected microbubble formation. OA temperature measurement showed a monotonic temperature increase in CW mode and a stepwise increase in MP mode, but no significant difference in the average temperature increase at the same average power, consistent with the temperature modeling. In conclusion, there is no difference in the average temperature rise between CW and MP modes at the same average power regardless of DC. At lower DC, however, more caution is required regarding mechanical damage due to microbubble formation. Full article
(This article belongs to the Special Issue Basics and Clinics of Retinal Laser Therapy)
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