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  3. Vol. 11 No. 3 (2020): Summer
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Vol. 11 No. 3 (2020)

June 2020

Choroidal Detachment Following Multi-spot Double Frequency Nd-YAG Retinal Photocoagulation – A Case Report

  • Sangeetha Rajagopal
  • Nivean Madhivanan
  • Lakshmi Mayilvakanam
  • Pratheebadevi Nivean

Journal of Lasers in Medical Sciences, Vol. 11 No. 3 (2020), 21 June 2020 , Page 345-347
Published: 2020-06-21

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Abstract

Introduction: Panretinal photocoagulation (PRP) remains the gold standard treatment for severe non-proliferative and proliferative diabetic retinopathy (PDR), as it reduces the risk of severe visual loss by more than 50%. In the conventional single-spot laser, the procedure involves the application of moderate-intensity burns of 200-500 microns, placed one spot-size apart to achieve a total of 1200-2000 applications in 2 or 3 sessions. The more advanced retina lasers like the Pattern Scan Laser (PASCAL) and the VITRA multi-spot laser are 532 nm frequency-doubled (Nd: YAG) solid-state lasers. These modern lasers enable the application of multiple laser burns in a rapid pre-determined sequence with reduced pulse duration (10-20 ms) to facilitate the PRP to be completed in a single sitting with lesser collateral tissue damage.

Case Report: Though multi-spot lasers have significantly reduced the adverse events when compared with the conventional single-spot lasers, we report a case of rare adverse events (serous choroidal detachment) following PRP with the VITRA multi-spot double frequency Nd-YAG (532 nm) laser.

Conclusion: Most of the serious choroidal detachments following PRP are self-limiting. We recommend complete retinal evaluation post-laser procedure even with the modern multisport laser to look for such adverse events.

Keywords:
  • panretinal photocoagulation
  • multispot laser
  • choroidal detachment
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How to Cite

Rajagopal, S., Madhivanan, N., Mayilvakanam, L., & Nivean, P. (2020). Choroidal Detachment Following Multi-spot Double Frequency Nd-YAG Retinal Photocoagulation – A Case Report. Journal of Lasers in Medical Sciences, 11(3), 345–347. Retrieved from https://journals.sbmu.ac.ir/jlms/article/view/27105
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References

Ding J, Wong TY. Current epidemiology of diabetic retinopathy and diabetic macular edema. Curr Diab Rep. 2012 Aug;12(4):346-54. doi: 10.1007/s11892-012-0283-6.

Early Treatment Diabetic Retinopathy Study Research Group. Early photocoagulation for diabetic retinopathy: ETDRS report number 9. Ophthalmology. 1991;98(5):766-85. doi: 10.1016/S0161-6420(13)38011-7.

Early Treatment Diabetic Retinopathy Study Research Group. Photocoagulation for diabetic macular edema: Early Treatment Diabetic Retinopathy Study Report Number 1. Arch Ophthalmol. 1985;103(12):1796-806. doi:10.1001/archopht.1985.01050120030015.

The Diabetic Retinopathy Study Research Group. Preliminary report on effects of photocoagulation therapy. Am J Ophthalmol. 1976;81(4):383-96. doi: 10.1016/0002-9394(76)90292-0.

Deschler EK, Sun JK, Silva PS. Side-effects and complications of laser treatment in diabetic retinal disease. Semin Ophthalmol. 2014;28(5-6):290-300. doi: 10.3109/08820538.2014.959198.

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Muqit MM, Marcellino GR, Henson DB, Young LB, Patton N, Charles SJ, et al. Single-session vs multiple-session pattern scanning laser panretinal photocoagulation in proliferative diabetic retinopathy: The Manchester Pascal Study. Arch Ophthalmol. 2010;128(5):525-33. doi: 10.1001/archophthalmol.2010.60.

Salman AG. Pascal laser versus conventional laser for treatment of diabetic retinopathy. Saudi J Ophthalmol. 2011;25(2):175-179. doi: 10.1016/j.sjopt.2011.01.006.

Natesh S, Ranganath A, Harsha K, Yadav NK, Bhujang BS. Choroidal detachment after PASCAL photocoagulation. Can J Ophthalmol. 2011;46(1):91. doi: 10.3129/i10-108.

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