The severity and characteristics of retinal injury following laser radiation derived from laser and tissue related factors.
We have previously shown that retinal damage following Nd:YAG Q-switched laser radiation in rabbits was related to
physical parameters, i.e. energy levels and number of pulses. Yet, an extremely large variability in the severity of the
damage was found under similar exposure paradigms, even within the same retina. This emphasizes the role of the
biological variables in the pathological mechanism of laser-induced retinal damage.
The aim of the present study was to further study histological parameters of the injury in relation to retinal site and to
elucidate their role in the initiation and characteristics of the damage, following various energy levels (10-50 &mgr;J) and
number of pulses (1-4).
Pigmented rabbits were exposed to Nd:YAG laser radiation (532nm, pulse duration: 20ns). Exposures were conducted in
retina tissue, adjacent to the optic nerve, with a total of 20 exposures per retina. Animals were sacrificed 15 min or 24
hours post exposure, eyes enucleated and processed for paraffin embedding. 4&mgr;m thick serial sections, stained with
hematoxylin and eosin, were examined under light microscopy.
Two major types of retinal damage were observed: focal edema confined to the pigmented epithelium and the
photoreceptor cells, and hemorrhages, associated with destruction of retinal tissue. While focal edema associated with
slight elevation of the photoreceptor layer seems to depend on the pigmented epithelium, hemorrhages were related also
to the choroid vasculature at the site of radiation. It is suggested that a thermo-mechanical mechanism is involved in laser
induced retinal hemorrhages at energies above 10-30&mgr;J (2-1 pulses, respectively).
An optical system designed for exposure of rabbit eyes to laser radiation and in-situ retinal damage assessment is presented. The laser radiation is of 2nd harmonic Q-switched Nd:YAG laser at 532 nm. The system is designed for multiple exposures at a regular grid array within a pre-determined region of the retina. Damage assessment is done in real time parallel to the exposure process. We present experimental results that demonstrate the versatility of the system for the determination of the threshold for laser-induced retinal damage in rabbit eye.
The aim of the present study was to characterize permissible exposure limits (MPE) for safety analysis, with an emphasis on the immediate retinal damage, following Nd:YAG Q-switched laser radiation, and to test its correlation to physical parameters. Pigmented rabbits were exposed to Nd:YAG laser radiation (532nm, pulse duration: 20ns) in various energies. Exposures were conducted in retina tissue, very close to the optic nerve, with a total of 20 exposures per retina. Retinas were viewed during the first 10 min following exposure, using an on-line digital video camera. Thereafter, animals were sacrificed for histological evaluation. A part of the retinas were evaluated 24 hours post exposure. A quantitative analysis of the clinical findings, based on a severity score scale and a morphometric analysis of the extent of the lesions, was used to test the statistical relationship with the laser energy and number of pulses. In addition, hemorrhage threshold values were computed using Probit Analysis. Retinal damage, at various levels of severity, was observed immediately after exposure to energies above 10μJ, characterized by edema and subretinal hemorrhages. The appearance and severity of the lesions varied among animals, between fellow eyes and even within the same retina. The relationship between severity and extent of lesions, and energy levels and number of pulses was evaluated. The ED50 for various, immediate types of hemorrhage was determined, and correlated to physical parameters. Histological observations strengthened the clinical findings. The results were discussed in accordance with photomechanical and thermal theories of laser-tissue interactions.
Purpose: The aim of the present study was to characterize permissible exposure limits (MPE) for safety analysis, with an emphasis on the immediate retinal damage following SHG of Nd:YAG Q-Switched laser radiation and to test its correlation to physical parameters. Methods: Pigmented rabbits (n=14) were exposed to single pulses of Nd:YAG laser radiation (532nm, pulse duration:8-12ns) in various energies ranging from 10 to 150 μJ. Exposures were conducted in retina tissue, very close to the optic nerve, with a total of 20 exposures per retina. Retinas were viewed during the first 15 min following exposure, using an on-line digital video camera. Thereafter, animals were sacrificed for histological evaluation. A quantitative analysis of the clinical findings, based on a severity score scale and a morphometric analysis of the extent of the lesions, was used to test the relationship with the laser energy. In addition, hemorrhage thresholds were computed using Probit Analysis. Results: Retinal damage, at various levels of severity, was observed immediately after exposure to energies above 26 μJ, characterized by edema and sub-retinal hemorrhages. The appearance and severity of the lesions varied among animals, between fellow eyes and even within the same retina. The ED50 for immediate pre-retinal hemorrhage was determined as 83μJ and the lesions’ diameter ranged from 141-640μ. A significant correlation (R=0.80, P<0.0001) was found between the extent of the lesions and energy levels. The diameter of the lesions showed a linear (P<0.008) increase with the laser energy. The histological observations indicated elevation of retinal layers and extensive damage in the outer segment of the photoreceptors and in the pigmented epithelial cells layer. Conclusions: A linear, laser-retinal tissue interaction was found immediately following exposure to single pulses of Nd:YAG laser radiation. It is suggested that unlike argon laser, which produces a thermal burn to the eye, Nd:YAG laser damage is a result of a combination of photo-mechanical and thermal mechanism.
Conference Committee Involvement (2)
Laser and Noncoherent Light Ocular Effects
20 January 2008 | San Jose, California, United States
Laser and Noncoherent Light Ocular Effects
21 January 2007 | San Jose, California, United States
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