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July 1986, Vol 104, No. 7 >
ARTICLE | July 1986

Morphologic Findings in the Rabbit Retina Following Irradiation With the Free-Running Neodymium-YAG Laser: Title and subTitle BreakDisruption of Bruch's Membrane and Its Effect on the Scarring Process in the Retina and Choroid FREE

Eugen van der Zypen, MD; Franz Fankhauser, MD; Kathy Raess, MD; Ceri England, PhD
[+] Author Affiliations

Accepted for publication Jan 31, 1986.

Reprint requests to Institute of Anatomy, University of Berne, Buhlstrasse 26, PO Box 139, CH-3000 Berne 9, Switzerland (Dr van der Zypen).


Arch Ophthalmol. 1986;104(7):1070-1077. doi:10.1001/archopht.1986.01050190128052
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• The scarring process induced within the retina and choroid of pigmented rabbits' eyes following irradiation with the neodymium-YAG laser (working in the free-running mode) was examined at the ultrastructural level. Scarring of the sensory retina proceeded rapidly and was well advanced two weeks after irradiation, whereas in the choroid, signs of repair were apparent only after six weeks. This difference in the rate of repair between the two tissues has a bearing on the scarring pattern in the retinochoroid as a whole. The severity of damage to the elastic component of Bruch's membrane also has important consequences in relation to the repair processes in the retina and choroid. Microfractures within this layer, while enabling migrating cells of various kinds to penetrate into the inner collagenous zone, did not prevent complete regeneration of the retinal pigment epithelium (RPE). In instances of greater rupture, however, RPE regeneration was found to stop at the border of the break, and the discontinuity produced within Bruch's membrane and the RPE allowed the glial scar to expand into the choroid. In this region, new formation of vessels was not found.

REFERENCES

1 +
Wallow IHL:  Repair of the pigment epithelial barrier following photocoagulation . Arch Ophthalmol 1984;;102:126-135.
2 +
Perry DD, Risco JM:  Choroidal microvascular repair after argon laser photocoagulation . Am J Ophthalmol 1982;;93:787-793.
3 +
Powell J, Bresnick GH, Yanoff M, et al:  Ocular effects of argon laser radiation: II. Histopathology of the chorioretinal lesions . Am J Ophthalmol 1971;;71:1267-1276.
4 +
Apple DJ, Goldberg MF, Wyhinny G:  Histopathology and ultrastructure of the argon laser lesion in human retinal and choroidal vasculatures . Am J Ophthalmol 1973;;75:595-609.
5 +
Marshall J:  Interactions between sensory cells, glial cells and the retinal pigment epithelium and their response to photocoagulation . Dev Ophthalmol 1981;;2:308-317.
6 +
Perry DD, Reddick RL, Risco JM:  Choroidal microvascular repair after argon laser photocoagulation: Ultrastructural observations . Invest Ophthalmol Vis Sci 1984;;25:1019-1026.
7 +
Smiddy WE, Fine SL, Quigley HA, et al:  Simulated treatment of recurrent choroidal neovascularization in primate retina: Comparative histopathologic findings . Arch Ophthalmol 1985;;103:428-433.
8 +
Peyman GA, Conway MD, House B:  Transpupillary CW YAG laser coagulation: A comparison with argon green and krypton red lasers . Ophthalmology 1983;;90:992-1002.
9 +
Wallow IHL, Birngruber R, Gabel VP, et al:  Netzhautreaktionen nach Intensivlichtbestrahlung: I. Schwellenläsionen: Experimentelle, morphologische und klinische Untersuchungen über pathologische und therapeutische Wirkungen von Laserlicht und von weissem Licht . Adv Ophthalmol 1975;;31:159-232.
10 +
Smiddy WE, Fine SL, Quigley HA, et al:  Comparison of krypton and argon laser photocoagulation: Results of simulated clinical treatment of primate retina . Arch Ophthalmol 1984;; 102:1086-1092.
11 +
Thomas EL, Apple DJ, Swartz M, et al:  Histopathology and ultrastructure of krypton and argon laser lesions in a human retinachoroid . Retina 1984;;4:22-39.
12 +
Peyman GA, Larson B:  Effects of the CW YAG laser on the human iris and retina . Ophthalmology 1984;;91:1034-1039.
13 +
Van der Zypen E, Fankhauser F:  Laser in the treatment of chronic simple glaucoma . Trans Ophthalmol Soc UK 1982;;102:147-153.
14 +
Fankhauser F, van der Zypen E, Kwasniewska S, et al:  The effect of thermal mode Nd:YAG laser radiation on vessels and ocular tissues: Experimental and clinical findings . Ophthalmology 1985;;92:419-426.
15 +
Fankhauser F, Kwasniewska S, van der Zypen E:  Irradiation of the posterior ocular segment with the neodymium-YAG laser in its free-running mode . Arch Ophthalmol 1985;; 103:1406-1412.
16 +
Fankhauser F, van der Zypen E:  Future of the laser in ophthalmology . Trans Ophthalmol Soc UK 1982;;102:159-163.
17 +
Brown GC, Green WR, Shah HG, et al:  Effects of the Nd:YAG laser on the primate retina and choroid . Ophthalmology 1984;;91:1397-1405.
18 +
Van der Zypen E, Fankhauser F, Raess K:  Choroidal reaction and vascular repair after chorioretinal photocoagulation with the freerunning neodymium-YAG laser . Arch Ophthalmol 1985;;103:580-589.
19 +
Geeraets WJ, Berry BS:  Ocular spectral characteristics as related to hazards from lasers and other light sources . Am J Ophthalmol 1968;; 66:15-20.
20 +
Rauhut D, Gabel VP, Birngruber R, et al:  Licht- und elektronenmikroskopische Untersuchungen von Neodymlaserläsionen bei Kaninchen . Ber Dtsch Ophthalmol Ges 1977;;74:407-412.
21 +
Kent PR, Spencer JAE, Smithwick GA, et al:  Laser-induced pathology of the rabbit retina: Comparison of three radiation wavelengths . Am J Optom Physiol Opt 1969;;46:847-854.
22 +
Sarks SH:  Ageing and degeneration in the macular region: A clinicopathologic study . Br J Ophthalmol 1976;;60:324-341.
23 +
Penfold P, Killingsworth M, Sarks SH:  An ultrastructural study of the role of leucocytes and fibroblasts in the breakdown of Bruch's membrane . Aust J Ophthalmol 1984;;12:23-31.
24 +
BenEzra D:  Neovasculogenic ability of prostaglandins, growth factors and synthetic chemoattractants . Am J Ophthalmol 1978;;86:455-461.
25 +
Oppenheim JJ, Gery I:  Interleukin I is more than an interleukin . Immunology 1982;; 3:113-119.
26 +
Polverini PJ, Cotran RS, Gimbrone MA Jr, et al:  Activated macrophages induce vascular proliferation . Nature 1977;;269:804-806.
27 +
DeLustro F, Sherer GK, LeRoy EC:  Human monocyte stimulation of fibroblast growth by a soluble mediator . J Reticuloendothel Soc 1980;; 28:519-532.
28 +
Martin BM, Gimbrone MA Jr, Unanue ER, et al:  Stimulation of nonlymphoid mesenchymal cell proliferation by macrophage-derived growth factor . J Immunol 1981;;126:1510-1515.
29 +
Sarks SH:  New vessel formation beneath the retinal pigment epithelium in senile eyes . Br J Ophthalmol 1973;;57:959-965.
30 +
Foos RY, Trese MT:  Chorioretinal juncture: Vascularization of Bruch's membrane in peripheral fundus . Arch Ophthalmol 1982;; 100:1492-1503.
31 +
Archer DB, Gardiner TA:  Morphologic, fluorescein angiographic, and light microscopic features of experimental choroidal neovascularization . Am J Ophthalmol 1981;;91:297-311.
32 +
Archer DB, Gardiner TA:  Electron microscopic features of experimental choroidal neovascularization . Am J Ophthalmol 1981;;91:433-457.
33 +
Augsburger JJ, Piro PA, Shields JA, et al:  Scatter photocoagulation for choroidovitreal neovascularization . Retina 1984;;4:171-176.
34 +
Snyder DA, Miech RP, Tamura H, et al:  Effects of laser photocoagulation on adenine nucleotides in rabbit retinas . Arch Ophthalmol 1976;;94:1004-1008.
35 +
Kuwabara T, Ishikawa Y, Kaiser-Kupfer MI:  Experimental model of gyrate atrophy in animals . Ophthalmology 1981;;88:331-334.
36 +
Henkind P, Gartner S:  The relationship between retinal pigment epithelium and the choriocapillaris . Trans Ophthalmol Soc UK 1983;; 103:444-447.
37 +
Korte GE, Reppucci V, Henkind P:  RPE destruction causes choriocapillary atrophy . Invest Ophthalmol Vis Sci 1984;;25:1135-1145.
38 +
Zweng HC, Rosan RC, Peabody RR, et al:  Experimental Q-switched ruby laser retinal damage . Arch Ophthalmol 1967;;78:634-640.
39 +
Wallow IHL, Tso MOM, Fine BS:  Retinal repair after experimental xenon arc photocoagulation . Am J Ophthalmol 1973;;75:32-52.

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1 +
Wallow IHL:  Repair of the pigment epithelial barrier following photocoagulation . Arch Ophthalmol 1984;;102:126-135.
2 +
Perry DD, Risco JM:  Choroidal microvascular repair after argon laser photocoagulation . Am J Ophthalmol 1982;;93:787-793.
3 +
Powell J, Bresnick GH, Yanoff M, et al:  Ocular effects of argon laser radiation: II. Histopathology of the chorioretinal lesions . Am J Ophthalmol 1971;;71:1267-1276.
4 +
Apple DJ, Goldberg MF, Wyhinny G:  Histopathology and ultrastructure of the argon laser lesion in human retinal and choroidal vasculatures . Am J Ophthalmol 1973;;75:595-609.
5 +
Marshall J:  Interactions between sensory cells, glial cells and the retinal pigment epithelium and their response to photocoagulation . Dev Ophthalmol 1981;;2:308-317.
6 +
Perry DD, Reddick RL, Risco JM:  Choroidal microvascular repair after argon laser photocoagulation: Ultrastructural observations . Invest Ophthalmol Vis Sci 1984;;25:1019-1026.
7 +
Smiddy WE, Fine SL, Quigley HA, et al:  Simulated treatment of recurrent choroidal neovascularization in primate retina: Comparative histopathologic findings . Arch Ophthalmol 1985;;103:428-433.
8 +
Peyman GA, Conway MD, House B:  Transpupillary CW YAG laser coagulation: A comparison with argon green and krypton red lasers . Ophthalmology 1983;;90:992-1002.
9 +
Wallow IHL, Birngruber R, Gabel VP, et al:  Netzhautreaktionen nach Intensivlichtbestrahlung: I. Schwellenläsionen: Experimentelle, morphologische und klinische Untersuchungen über pathologische und therapeutische Wirkungen von Laserlicht und von weissem Licht . Adv Ophthalmol 1975;;31:159-232.
10 +
Smiddy WE, Fine SL, Quigley HA, et al:  Comparison of krypton and argon laser photocoagulation: Results of simulated clinical treatment of primate retina . Arch Ophthalmol 1984;; 102:1086-1092.
11 +
Thomas EL, Apple DJ, Swartz M, et al:  Histopathology and ultrastructure of krypton and argon laser lesions in a human retinachoroid . Retina 1984;;4:22-39.
12 +
Peyman GA, Larson B:  Effects of the CW YAG laser on the human iris and retina . Ophthalmology 1984;;91:1034-1039.
13 +
Van der Zypen E, Fankhauser F:  Laser in the treatment of chronic simple glaucoma . Trans Ophthalmol Soc UK 1982;;102:147-153.
14 +
Fankhauser F, van der Zypen E, Kwasniewska S, et al:  The effect of thermal mode Nd:YAG laser radiation on vessels and ocular tissues: Experimental and clinical findings . Ophthalmology 1985;;92:419-426.
15 +
Fankhauser F, Kwasniewska S, van der Zypen E:  Irradiation of the posterior ocular segment with the neodymium-YAG laser in its free-running mode . Arch Ophthalmol 1985;; 103:1406-1412.
16 +
Fankhauser F, van der Zypen E:  Future of the laser in ophthalmology . Trans Ophthalmol Soc UK 1982;;102:159-163.
17 +
Brown GC, Green WR, Shah HG, et al:  Effects of the Nd:YAG laser on the primate retina and choroid . Ophthalmology 1984;;91:1397-1405.
18 +
Van der Zypen E, Fankhauser F, Raess K:  Choroidal reaction and vascular repair after chorioretinal photocoagulation with the freerunning neodymium-YAG laser . Arch Ophthalmol 1985;;103:580-589.
19 +
Geeraets WJ, Berry BS:  Ocular spectral characteristics as related to hazards from lasers and other light sources . Am J Ophthalmol 1968;; 66:15-20.
20 +
Rauhut D, Gabel VP, Birngruber R, et al:  Licht- und elektronenmikroskopische Untersuchungen von Neodymlaserläsionen bei Kaninchen . Ber Dtsch Ophthalmol Ges 1977;;74:407-412.
21 +
Kent PR, Spencer JAE, Smithwick GA, et al:  Laser-induced pathology of the rabbit retina: Comparison of three radiation wavelengths . Am J Optom Physiol Opt 1969;;46:847-854.
22 +
Sarks SH:  Ageing and degeneration in the macular region: A clinicopathologic study . Br J Ophthalmol 1976;;60:324-341.
23 +
Penfold P, Killingsworth M, Sarks SH:  An ultrastructural study of the role of leucocytes and fibroblasts in the breakdown of Bruch's membrane . Aust J Ophthalmol 1984;;12:23-31.
24 +
BenEzra D:  Neovasculogenic ability of prostaglandins, growth factors and synthetic chemoattractants . Am J Ophthalmol 1978;;86:455-461.
25 +
Oppenheim JJ, Gery I:  Interleukin I is more than an interleukin . Immunology 1982;; 3:113-119.
26 +
Polverini PJ, Cotran RS, Gimbrone MA Jr, et al:  Activated macrophages induce vascular proliferation . Nature 1977;;269:804-806.
27 +
DeLustro F, Sherer GK, LeRoy EC:  Human monocyte stimulation of fibroblast growth by a soluble mediator . J Reticuloendothel Soc 1980;; 28:519-532.
28 +
Martin BM, Gimbrone MA Jr, Unanue ER, et al:  Stimulation of nonlymphoid mesenchymal cell proliferation by macrophage-derived growth factor . J Immunol 1981;;126:1510-1515.
29 +
Sarks SH:  New vessel formation beneath the retinal pigment epithelium in senile eyes . Br J Ophthalmol 1973;;57:959-965.
30 +
Foos RY, Trese MT:  Chorioretinal juncture: Vascularization of Bruch's membrane in peripheral fundus . Arch Ophthalmol 1982;; 100:1492-1503.
31 +
Archer DB, Gardiner TA:  Morphologic, fluorescein angiographic, and light microscopic features of experimental choroidal neovascularization . Am J Ophthalmol 1981;;91:297-311.
32 +
Archer DB, Gardiner TA:  Electron microscopic features of experimental choroidal neovascularization . Am J Ophthalmol 1981;;91:433-457.
33 +
Augsburger JJ, Piro PA, Shields JA, et al:  Scatter photocoagulation for choroidovitreal neovascularization . Retina 1984;;4:171-176.
34 +
Snyder DA, Miech RP, Tamura H, et al:  Effects of laser photocoagulation on adenine nucleotides in rabbit retinas . Arch Ophthalmol 1976;;94:1004-1008.
35 +
Kuwabara T, Ishikawa Y, Kaiser-Kupfer MI:  Experimental model of gyrate atrophy in animals . Ophthalmology 1981;;88:331-334.
36 +
Henkind P, Gartner S:  The relationship between retinal pigment epithelium and the choriocapillaris . Trans Ophthalmol Soc UK 1983;; 103:444-447.
37 +
Korte GE, Reppucci V, Henkind P:  RPE destruction causes choriocapillary atrophy . Invest Ophthalmol Vis Sci 1984;;25:1135-1145.
38 +
Zweng HC, Rosan RC, Peabody RR, et al:  Experimental Q-switched ruby laser retinal damage . Arch Ophthalmol 1967;;78:634-640.
39 +
Wallow IHL, Tso MOM, Fine BS:  Retinal repair after experimental xenon arc photocoagulation . Am J Ophthalmol 1973;;75:32-52.

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