Targeted photocoagulation of peripheral ischemia to treat rebound edema

Michael A Singer,1 Colin S Tan,2 Krishna R Surapaneni,3 Srinivas R Sadda4 1Medical Center Ophthalmology Associates, San Antonio, TX, USA; 2National Healthcare Group Eye Institute, Tan Tock Seng Hospital, Singapore; 3University of Texas Health Science Center at San Antonio, San Antonio, TX, USA; 4D...

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Autores principales:	Singer MA, Tan CS, Surapaneni KR, Sadda SR
Formato:	article
Lenguaje:	EN
Publicado:	Dove Medical Press 2015
Materias:	Ophthalmology RE1-994
Acceso en línea:	https://doaj.org/article/efb84984989f4c26a6932936c78edb1f
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spelling	oai:doaj.org-article:efb84984989f4c26a6932936c78edb1f2021-12-02T02:08:22ZTargeted photocoagulation of peripheral ischemia to treat rebound edema1177-5483https://doaj.org/article/efb84984989f4c26a6932936c78edb1f2015-02-01T00:00:00Zhttp://www.dovepress.com/targeted-photocoagulation-of-peripheral-ischemia-to-treat-rebound-edem-peer-reviewed-article-OPTHhttps://doaj.org/toc/1177-5483 Michael A Singer,1 Colin S Tan,2 Krishna R Surapaneni,3 Srinivas R Sadda4 1Medical Center Ophthalmology Associates, San Antonio, TX, USA; 2National Healthcare Group Eye Institute, Tan Tock Seng Hospital, Singapore; 3University of Texas Health Science Center at San Antonio, San Antonio, TX, USA; 4Doheny Eye Institute, Los Angeles, CA, USA Introduction: Peripheral retinal ischemia not detectable by conventional fluorescein angiography has been proposed to be a driving force for rebound edema in retinal vein occlusions. In this report, we examine the treatment of peripheral retinal ischemia with targeted retinal photocoagulation (TRP) to manage a patient’s rebound edema.Methods: To assess the extent of peripheral nonperfusion, an Optos 200Tx device was used. To target the treatment to peripheral ischemia areas, a Navilas Panretinal Laser was used.Results: A 64-year-old male with a central retinal vein occlusion and a visual acuity 20/300, and central macular thickness 318 µm presented with rubeosis. Angiography revealed extensive peripheral nonperfusion. Despite TRP to areas of irreversible ischemia, after 2 months, he continued show rubeosis and rebound edema. Additional TRP laser was repeatedly added more posteriorly to areas of reversible nonperfusion, resulting in eventual resolution of rubeosis and edema.Conclusion: In this study, we demonstrate the use of widefield imaging with targeted photocoagulation of peripheral ischemia to treat rebound edema, while preserving most peripheral vision. In order to treat rebound edema, extensive TRP, across reversible and nonreversible areas of ischemia, had to be performed – not just in areas of nonreversible peripheral ischemia. These areas need to be mapped during episodes of rebound edema, when ischemia is at its maximum. In this way, by doing the most TRP possible, the cycle of rebound edema can be broken. Keywords: macular edema, retinal vein occlusion Singer MATan CSSurapaneni KRSadda SRDove Medical PressarticleOphthalmologyRE1-994ENClinical Ophthalmology, Vol 2015, Iss default, Pp 337-341 (2015)
institution	DOAJ
collection	DOAJ
language	EN
topic	Ophthalmology RE1-994
spellingShingle	Ophthalmology RE1-994 Singer MA Tan CS Surapaneni KR Sadda SR Targeted photocoagulation of peripheral ischemia to treat rebound edema
description	Michael A Singer,1 Colin S Tan,2 Krishna R Surapaneni,3 Srinivas R Sadda4 1Medical Center Ophthalmology Associates, San Antonio, TX, USA; 2National Healthcare Group Eye Institute, Tan Tock Seng Hospital, Singapore; 3University of Texas Health Science Center at San Antonio, San Antonio, TX, USA; 4Doheny Eye Institute, Los Angeles, CA, USA Introduction: Peripheral retinal ischemia not detectable by conventional fluorescein angiography has been proposed to be a driving force for rebound edema in retinal vein occlusions. In this report, we examine the treatment of peripheral retinal ischemia with targeted retinal photocoagulation (TRP) to manage a patient’s rebound edema.Methods: To assess the extent of peripheral nonperfusion, an Optos 200Tx device was used. To target the treatment to peripheral ischemia areas, a Navilas Panretinal Laser was used.Results: A 64-year-old male with a central retinal vein occlusion and a visual acuity 20/300, and central macular thickness 318 µm presented with rubeosis. Angiography revealed extensive peripheral nonperfusion. Despite TRP to areas of irreversible ischemia, after 2 months, he continued show rubeosis and rebound edema. Additional TRP laser was repeatedly added more posteriorly to areas of reversible nonperfusion, resulting in eventual resolution of rubeosis and edema.Conclusion: In this study, we demonstrate the use of widefield imaging with targeted photocoagulation of peripheral ischemia to treat rebound edema, while preserving most peripheral vision. In order to treat rebound edema, extensive TRP, across reversible and nonreversible areas of ischemia, had to be performed – not just in areas of nonreversible peripheral ischemia. These areas need to be mapped during episodes of rebound edema, when ischemia is at its maximum. In this way, by doing the most TRP possible, the cycle of rebound edema can be broken. Keywords: macular edema, retinal vein occlusion
format	article
author	Singer MA Tan CS Surapaneni KR Sadda SR
author_facet	Singer MA Tan CS Surapaneni KR Sadda SR
author_sort	Singer MA
title	Targeted photocoagulation of peripheral ischemia to treat rebound edema
title_short	Targeted photocoagulation of peripheral ischemia to treat rebound edema
title_full	Targeted photocoagulation of peripheral ischemia to treat rebound edema
title_fullStr	Targeted photocoagulation of peripheral ischemia to treat rebound edema
title_full_unstemmed	Targeted photocoagulation of peripheral ischemia to treat rebound edema
title_sort	targeted photocoagulation of peripheral ischemia to treat rebound edema
publisher	Dove Medical Press
publishDate	2015
url	https://doaj.org/article/efb84984989f4c26a6932936c78edb1f
work_keys_str_mv	AT singerma targetedphotocoagulationofperipheralischemiatotreatreboundedema AT tancs targetedphotocoagulationofperipheralischemiatotreatreboundedema AT surapanenikr targetedphotocoagulationofperipheralischemiatotreatreboundedema AT saddasr targetedphotocoagulationofperipheralischemiatotreatreboundedema
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Targeted photocoagulation of peripheral ischemia to treat rebound edema

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