Transluminal Nd:YAG laser embolysis: A reasonable method to reperfuse occluded branch retinal arteries
Introduction. Central retinal artery occlusion (CRAO) and branch retinal artery occlusion (BRAO) result in partial or complete retinal ischemia and sudden loss of vision; at this moment, there is no effective therapy for CRAO and BRAO. Transluminal Nd:YAG laser embolysis (TYE) represents a...
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| Main Authors: | , , |
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| Format: | Article |
| Language: | English |
| Published: |
Ministry of Defence of the Republic of Serbia, University of Defence, Belgrade
2014-01-01
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| Series: | Vojnosanitetski Pregled |
| Subjects: | |
| Online Access: | http://www.doiserbia.nb.rs/img/doi/0042-8450/2014/0042-84501300056S.pdf |
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| Summary: | Introduction. Central retinal artery occlusion (CRAO) and branch retinal
artery occlusion (BRAO) result in partial or complete retinal ischemia and
sudden loss of vision; at this moment, there is no effective therapy for CRAO
and BRAO. Transluminal Nd:YAG laser embolysis (TYE) represents a therapeutic
approach used for retinal vascular occlusive diseases. The main indication is
branch retinal artery occlusion with visible embolus; for central retinal
artery occlusion this tehnique is hardly applicable. The principle of this
method consists of intravascular embolus breakage using the 1064 nm Nd:YAG
laser, focused on the embolus surface. Case report. We presented 5 cases with
BRAO, 3 with infero-temporal and 2 with supero-temporal BRAO, all of them
treated with TYE, with variable results. All the patients had a visible
embolus within the BRA, the laser applications being delivered directly to
the embolus. Conclusion. Despite our short-term experience regarding this
therapeutical approach, we can resume that the moment of emboli distruction,
as close as possible to the onset of the occlusion, is decisive for regaining
vision and that applying the procedure correctly is superior to observation
in most cases. Worldwide experience with TYE is still limited, but the
technique seems feasible also when treating CRAO caused by visible emboli on
the optic disc surface. This most certainly calls for random trials for
identifying precisely the role of TYE in treatment of retinal occlusion
pathology, though the relatively small number of properly diagnosed cases
affects this objective. In all cases, the risks of TYE must be weighed
against the possibility of severe and permanent loss of vision secondary to
retinal artery occlusions. |
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| ISSN: | 0042-8450 |