T Mark Johnson1, Bert M Glaser. 1. National Retina Institute, Suite 101, 5530 Wisconsin Ave., Chevy Chase, MD 20815, USA. mjohnson@bmgnri.com
Abstract
BACKGROUND: Retinal-choroidal anastomoses (RCA) are a common finding in advanced cases of age-related macular degeneration. These high-flow lesions are associated with extensive subretinal exudation. This study examines the role of high-energy, short-duration (micropulse) laser pulses in effectively closing these shunts and reducing subretinal fluid. METHODS: Nineteen consecutive eyes with advanced age-related macular degeneration undergoing treatment of RCAs to reduce subretinal exudation in a referral-only retina practice were reviewed retrospectively. RCA were identified using high-speed indocyanine green angiography. RCA were closed using a high-energy, short-duration laser pulse technique. Outcome measures included visual acuity, resolution of subretinal fluid and persistence of RCA. RESULTS: Nineteen eyes with RCA associated with macular degeneration were successfully treated. Mean baseline visual acuity was 20/140 (HM to 20/50). One hundred percent of eyes had subretinal exudation and 73% had subretinal fibrosis at the time initial treatment. At mean follow-up of 11.7 (2-23) months, patients had undergone an average of 3.52 (1-12) sessions of laser treatment. Average final visual acuity was 20/146 (CF to 20/40). Fifty-three percent of eyes had complete resolution of subretinal fluid. One hundred percent had subretinal fibrosis. Forty-three percent had complete closure of RCA. No significant complications were encountered. CONCLUSION: High-energy, short-duration laser appears to be a reproducible technique to obtain closure of RCA associated with advanced macular degeneration. It appears to be effective in reducing subretinal exudation associated with these lesions. The technique is associated with stabilization of visual acuity without significant risk of complication.
BACKGROUND:Retinal-choroidal anastomoses (RCA) are a common finding in advanced cases of age-related macular degeneration. These high-flow lesions are associated with extensive subretinal exudation. This study examines the role of high-energy, short-duration (micropulse) laser pulses in effectively closing these shunts and reducing subretinal fluid. METHODS: Nineteen consecutive eyes with advanced age-related macular degeneration undergoing treatment of RCAs to reduce subretinal exudation in a referral-only retina practice were reviewed retrospectively. RCA were identified using high-speed indocyanine green angiography. RCA were closed using a high-energy, short-duration laser pulse technique. Outcome measures included visual acuity, resolution of subretinal fluid and persistence of RCA. RESULTS: Nineteen eyes with RCA associated with macular degeneration were successfully treated. Mean baseline visual acuity was 20/140 (HM to 20/50). One hundred percent of eyes had subretinal exudation and 73% had subretinal fibrosis at the time initial treatment. At mean follow-up of 11.7 (2-23) months, patients had undergone an average of 3.52 (1-12) sessions of laser treatment. Average final visual acuity was 20/146 (CF to 20/40). Fifty-three percent of eyes had complete resolution of subretinal fluid. One hundred percent had subretinal fibrosis. Forty-three percent had complete closure of RCA. No significant complications were encountered. CONCLUSION: High-energy, short-duration laser appears to be a reproducible technique to obtain closure of RCA associated with advanced macular degeneration. It appears to be effective in reducing subretinal exudation associated with these lesions. The technique is associated with stabilization of visual acuity without significant risk of complication.
Authors: L A Yannuzzi; S Negrão; T Iida; C Carvalho; H Rodriguez-Coleman; J Slakter; K B Freund; J Sorenson; D Orlock; N Borodoker Journal: Retina Date: 2001 Impact factor: 4.256
Authors: J S Slakter; L A Yannuzzi; U Schneider; J A Sorenson; A Ciardella; D R Guyer; R F Spaide; K B Freund; D A Orlock Journal: Ophthalmology Date: 2000-04 Impact factor: 12.079
Authors: Rufino M Silva; José R Faria de Abreu; António Travassos; José G Cunha-Vaz Journal: Graefes Arch Clin Exp Ophthalmol Date: 2004-01-31 Impact factor: 3.117
Authors: J M Garden; O T Tan; R Kerschmann; J Boll; H Furumoto; R R Anderson; J A Parrish Journal: J Invest Dermatol Date: 1986-11 Impact factor: 8.551
Authors: Quan Findlay; Andrew I Jobling; Kirstan A Vessey; Ursula Greferath; Joanna A Phipps; Robyn H Guymer; Erica L Fletcher Journal: Eye (Lond) Date: 2018-03-09 Impact factor: 3.775