| 발표일자: |
2013년 04월 20일 (토) |
| 발표시간: |
16:04~16:12 |
| 발표번호: |
망막F-039 |
| 발표장소: |
B방 |
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| Selective retina treatment (SRT) automatically controlled by real-time reflectometry in a rabbit model |
| Department of Ophthalmology, YeouidoSt. Mary’s Hospital, College of Medicine, The Catholic University of Korea(1), Medical Laser Center, Luebeck, Germany (2) |
| Young Jung Roh(1), Young Gun Park(1), Seungbum Kang(1), Eric Seifert(2), Dirk Theisen-Kunde(2), Ralf Brinkmann(2) |
| 목적 : Selective retina therapy (SRT) targets the retinal pigment epithelium (RPE) with repetitive microsecond laser pulseswhile causing no thermal damage to the adjacent photoreceptors. Our purpose was to evaluate the safety, selectivity and healing of the retinal lesions by using an automaticdosimetry technique for SRT basing on the evaluation of reflected light during irradiation. 방법 : Ten eyes of Chinchilla Bastard rabbits were treated with SRT (wavelength: 527 nm, pulse duration: 1.7 µs, repetition rate: 100Hz, max. number of pulses in a burst: 30, pulse energy: 110 μJ, retinal spot diameter: 200㎛)using a Q-switched Nd-YLF laser controlled by real-time reflectometricdosimetry. The technique ramps up the pulse energy within in a burst until microbubble formation is detected and then ceases laser irradiation. After treatment,fundus photography, optical coherence tomography (OCT) and fluorescein angiography were performed at 3 time points. Histological analysis was done.결과 : Typical fundus photographs obtained 1 hour after irradiation show that all lesions produced by SRT were not visible ophthalmoscopically at all energy levels used. The lesions could be detected only by angiography. No sign of disruptive effects was observed.Fundus examination showed focal pigmented speckle due to healing status and no fluorescein leakage after 7 days. OCT images revealed the structure of photoreceptor was preserved, but a disrupted RPE layer as expected. By 3 weeks, histology showed selective RPE damage without inner retinal effects and focally proliferated. 결론 : SRT achieves selective targeting of the RPE without permanent scarring or inner retinal damage. Reflectometry is a reliable noncontact technique tomonitor RPE disintegration and may serve as real-time dosimetry control during SRT. |
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