Temperature-controlled retinal photocoagulation--a step toward automated laser treatment

Investigative Ophthalmology & Visual Science
Stefan KoinzerJohann Roider

Abstract

Retinal laser photocoagulation carries the risk of overtreatment due to effect variation of identically applied lesions. The degree of coagulation depends on the induced temperature increase and on exposure time. We introduce temperature controlled photocoagulation (TCP), which uses optoacoustics to determine individually exposure times necessary to create reproducible lesions. Optoacoustic temperature measurement relies on pressure waves that are excited in the retinal tissue by repetitive low-energy laser pulses. Signal amplitudes correlate with tissue temperature and are detected by a transducer in the laser contact lens. We used a continuous wave (CW) photocoagulator for treatment irradiation and superimposed probe laser pulses for simultaneous temperature measurement. Optoacoustic data of 1500 lesions (rabbit) were evaluated to develop an algorithm that controls exposure times automatically in TCP. Lesion diameters of 156 TCP lesions were compared to 156 non-controlled lesions. Histology was performed after 1 hour, and 1 and 4 weeks. TCP resulted in exposure times from 4 to 800 ms depending on laser power chosen. Ophthalmoscopic and histologic lesion diameters were independent of power between 14 and 200 mW. TCP lesions ba...Continue Reading

Citations

Sep 17, 2013·Graefe's Archive for Clinical and Experimental Ophthalmology = Albrecht Von Graefes Archiv Für Klinische Und Experimentelle Ophthalmologie·Stefan KoinzerJohann Roider
Jun 28, 2012·Journal of Biomedical Optics·Ralf BrinkmannReginald Birngruber
Aug 28, 2014·Graefe's Archive for Clinical and Experimental Ophthalmology = Albrecht Von Graefes Archiv Für Klinische Und Experimentelle Ophthalmologie·Alexandra E HoehStefan Dithmar
Jul 14, 2016·Graefe's Archive for Clinical and Experimental Ophthalmology = Albrecht Von Graefes Archiv Für Klinische Und Experimentelle Ophthalmologie·Mark SaegerStefan Koinzer
Nov 23, 2017·Journal of Biomedical Optics·Alexander BaadeRalf Brinkmann
Sep 28, 2016·Journal of Biomedical Optics·Kerstin SchlottRalf Brinkmann
Feb 7, 2015·Biomedical Optics Express·Kazuhiro KurokawaYoshiaki Yasuno
Jan 26, 2017·Vestnik oftalmologii·A V Bol'shunovS M Shmeleva
May 31, 2013·Acta Ophthalmologica·Stefan KoinzerJohann Roider
Mar 30, 2019·International Journal of Hyperthermia : the Official Journal of European Society for Hyperthermic Oncology, North American Hyperthermia Group·Yoko MiuraRalf Brinkmann

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