Non-Damaging Laser Therapy of the Macula: Titration Algorithm and Tissue Response
Dr. Daniel Palanker
Monday, January 26, 2015
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Chapters
Financial Disclosure
Mechanism of Retinal Photocoagulation
Dynamics of Retinal Photocoagulation
Retinal Heating with 150mW, 10 ms Pulse
Cellular Damage Zone (150mW, 10ms)
Intense Burn
Acute Damage to RPE
Barely Visible
Redistribution of Photoreceptors
Clinical Endpoints
Relating Pulse Energy and Duration to Clinical Grade and Arrhenius Integral
Barely Visible 100%, 200μm
50% Energy
30% Energy, 3 Days
Heat Shock Protein Expression: Bioluminescence of HSP-70
Expression of Heat Shock Protein DSP70: Treated/Control
Barely-Visible Burns (100%)
Non-damaging Exposures (30%)
Heat Shock Protein Expression
Alpha-A Crystallin in RPE
No Expression of Beta-Crystallins in RPE
α Crystallins
Endpoint Management Algorithm
EndPoint Management GUI
EpM Treatment Area for Macular Edema
Central Serous Retinopathy
Macular Edema Secondary to Branch Retinal Vein Occlusion
Diabetic Macular Edema
Transpupilar Thermal Therapy for Treatment of Choroidal Neovascularisation
Retinal Temperature During Micropulse Laser Therapy
Arrhenius Integral Across the Retina after Micropulse and CW Exposures
Conclusions
Importance of Proper Dosimetry
Acknowledgements
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