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Fundus Autofluorescence and Fourier-Domain Optical Coherence Tomography Imaging of 10 and 20 millisecond Pascal® Retinal Photocoagulation Treatment
  1. Mahiul MK Muqit (mmmk3{at}aol.com),
  2. Jane CB Gray,
  3. George R Marcellino,
  4. David Henson,
  5. Lorna B Young,
  6. Stephen J Charles,
  7. George S Turner,
  8. Paulo E Stanga (retinaspecialist{at}btinternet.com)
  1. Manchester Royal Eye Hospital, United Kingdom
  2. Manchester Royal Eye Hospital, United Kingdom
  3. OptiMedica Corporation, United States
  4. Manchester Royal Eye Hospital, United Kingdom
  5. Manchester Royal Eye Hospital, United Kingdom
  6. Manchester Royal Eye Hospital, United Kingdom
  7. Manchester Royal Eye Hospital, United Kingdom
  8. Manchester Royal Eye Hospital, United Kingdom

    Abstract

    Aim: To report the evolution of pattern scanning laser (Pascal®) photocoagulation burns in the treatment of diabetic retinopathy, using Fourier-Domain optical coherence tomography (FD-OCT) and fundus autofluorescence (AF), and to evaluate these characteristics with clinically visible alterations in outer retina (OR) and retinal pigment epithelium (RPE).

    Methods: Standard red-free and colour fundus photography (FP), FD-OCT, and fundus camera-based AF were performed in 17 eyes of 11 patients following macular and panretinal photocoagulation (PRP).

    Results: One hour following Pascal® application, visibility of threshold burns on FP was incomplete. AF enabled visualization of complete treatment arrays at one hour, with hypo-autofluorescence at sites of each laser burn. AF signals accurately correlated with localised increased optical reflectivity within the outer retina on FD-OCT. AF signals became hyper-autofluorescent at 1 week, and corresponded on FD-OCT to defects at the junction of the inner and outer segments of the photoreceptors (JI/OSP) and upper surface of RPE. A 10ms macular laser pulse produced a localized defect at the level of JI/OSP and RPE. Macular and 20ms PRP burns did not enlarge at one year and 18 months follow-up respectively.

    Conclusions: We report the in vivo spatial localization and clinical correlation of medium-pulse Pascal® photocoagulation burns within outer retina and RPE, using high-resolution FD-OCT and AF. Ophthalmoscopically invisible and threshold Pascal® burns may be accurately localized and mapped by AF and FD-OCT, with monitoring of over time.

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