0
December 1992, Vol 110, No. 12 >
ARTICLE | December 1992

Response of the Retinal Pigment Epithelium to Selective Photocoagulation FREE

Johann Roider, MD; Norman A. Michaud, MS; Thomas J. Flotte, MD; Reginald Birngruber, PhD
[+] Author Affiliations

Accepted for publication April 2, 1992.

Presented at the annual meeting of the Association for Research in Vision and Ophthalmology, Sarasota, Fla, April 23, 1991.

Reprint requests to Medizinische Universität zu Lübeck, Klinik für Augenheilkunde, Ratzeburger Allee 160, W-2400 Lübeck 1, Germany (Dr Roider).


Arch Ophthalmol. 1992;110(12):1786-1792. doi:10.1001/archopht.1992.01080240126045
Text Size: A A A
Published online
Article
References
Comments

• Multiple short argon laser pulses can coagulate the retinal pigment epithelium selectively, while sparing the adjacent neural retina and choroid; in contrast, continuous-wave laser irradiation typically damages the neural retina and choroid. The healing response to selective photocoagulation of the retinal pigment epithelium was studied in rabbits during a period of 4 weeks. The lesions were never visible ophthalmoscopically. During the healing period, the epithelium was reformed by a single sheet of hypertrophic retinal pigment epithelial cells. In contrast to continuous-wave photocoagulation, only minimal inflammatory response was found. Retinal pigment epithelial cells showed clear signs of viability, eg, phagocytized outer segments. The local edema in the photoreceptor layer and subretinal space found in the early stage disappeared when the blood-retinal barrier was reestablished. The choriocapillaris remained unaffected. No subsequent damage to the photoreceptors was found. This type of photocoagulation may be useful for retinal pigment epithelium—related diseases, eg, diffuse diabetic macular edema.

REFERENCES

1 +
Wolbarsht MT, Landers MB.  The rationale of photocoagulation therapy for proliferative diabetic retinopathy: a review and model . Ophthalmic Surg . 1980;;11:235-245.
2 +
Tso MO, Cunha-Vaz JG, Shih C, Jones CW.  Clinicopathologic study of blood retinal barrier in experimental diabetes mellitus . Arch Ophthalmol . 1980;;98:2032-2040.
3 +
Glaser BM, Campochiaro PA, Davis JL, Jerdan JA.  Retinal pigment epithelial cells release inhibitors of neovascularization . Ophthalmology . 1987;;94:780-784.
4 +
Bresnick GH.  Diabetic maculopathy: a critical review highlighting diffuse macular edema . Ophthalmology . 1983;;90:1301-1317.
5 +
Wallow IH.  Repair of the pigment epithelial barrier following photocoagulation . Arch Ophthalmol . 1984;;102:126-135.
6 +
Gabel VP, Birngruber R, Hillenkamp F.  Visible and near infrared light absorption in pigment epithelium and choroid . In: Shimizu K, ed. International Congress Series No. 450, XXIII Concilium Ophthalmologicum, Kyoto . Princeton, NJ: Excerpta Medica; 1978;:658-662.
7 +
Anderson R, Parrish JA.  Selective photothermolysis . Science . 1983;;220:524-527.
8 +
Birngruber R, Hillenkamp F, Gabel VP.  Theoretical investigations of laser thermal retinal injury . Health Phys . 1985;;48:781-796.
9 +
Roider J, Birngruber R.  Spatial confinement of photocoagulation effects using high repetition rate laser pulses . In: Conference on Lasers and Electro-Optics, Technical Digest Series . Washington, DC: Optical Society of America; 1990;;7:168-169.
10 +
Marshall J.  Interactions between sensory cells, glia cells and the retinal pigment epithelium and their response to photocoagulation . Dev Ophthalmol . 1981;;2:308-317.
11 +
Pollack A, Korte GE.  Repair of retinal pigment epithelium and its relationship with capillary endothelium after krypton photocoagulation . Invest Ophthalmol Vis Sci . 1990;;31:890-898.
12 +
Wallow I.  Long term changes in photocoagulation burns . Dev Ophthalmol . 1981;;2:318-327.
13 +
Wallow IH, Tso MO.  Repair after xenon arc photocoagulation, II: a clinical and light microscopic study of the evolution of retinal lesions in the rhesus monkey . Am J Ophthalmol . 1973;;75:610-626.
14 +
Birngruber R, Gabel VP, Hillenkamp F.  Experimental studies of laser thermal retinal injury . Health Phys . 1983;;44:519-531.
15 +
Yanoff M, Fine BS. Ocular Pathology; A Text and Atlas . 2nd ed. New York, NY: Harper & Row Publishers Inc; 1982;:196-201.
16 +
Del Priore LV, Glaser BM, Quigley HA, Green R.  Response of pig retinal pigment epithelium to laser photocoagulation in organ culture . Arch Opthalmol . 1989;;107:119-122.
17 +
Hergott GJ, Sandig M, Kalnins VI.  Cytoskeletal organization of migrating retinal pigment epithelial cells during wound healing in organ culture . Cell Motil Cytoskeleton . 1989;;13:83-93.
18 +
Marshall J, Fankhauser F, Lotmar W, Roulier W.  Pathology of short pulse retinal photocoagulations using the Goldmann contact lens . Graefes Arch Clin Exp Ophthalmol . 1971;;182:154-169.
19 +
Bülow N.  The process of wound healing of the avascular outer layers of the retina, light- and electron-microscopic studies on laser lesions of monkey eyes . Acta Ophthalmol Suppl (Copenh) . 1978;;139:7-60.
20 +
Inomata H.  Wound healing after xenon arc photocoagulation in the rabbit retina . Ophthalmologica . 1975;;170:462-474.
21 +
Machemer R, Laqua H.  Pigment epithelium proliferation in retinal detachment (massive periretinal proliferation) . Am J Ophthalmol . 1975;;80:1-23.
22 +
Hergott GJ, Gallie B, Kalnins VI.  Proliferating cell nuclear antigen (PCNA) in migrating retinal pigment epithelial cells (RPE) during wound healing in organ culture . Invest Ophthalmol Vis Sci . 1991;;32:1219. Abstract.
23 +
Pollack A, Korte GE, Weitzner AL, Henkind P.  Ultrastructure of Bruch's membrane after krypton laser photocoagulation, I: breakdown of Bruch's membrane . Arch Ophthalmol . 1986;;104:1372-1375.
24 +
Marmor MF.  Control of subretinal fliud: experimental and clinical studies . Eye . 1990;;4:340-344.
25 +
Miller SS, Hughes BA, Machen TE.  Fluid transport across retinal pigment epithelium is inhibited by cyclic AMP . Proc Natl Acad Sci U S A . 1982;;79:2111-2115.
26 +
Zweig K, Cunha-Vaz J, Peyman G, Stein M, Raichand M.  Effect of argon laser photocoagulation on fluorescein transport across the blood retinal barrier . Exp Eye Res . 1981;;32:323-329.
27 +
Korte GE, Reppucci V, Henkind P.  RPE destruction causes choriocapillary atrophy . Invest Ophthalmol Vis Sci . 1984;;25:1135-1144.
28 +
Henkind P, Gartner S.  The relationship between retinal pigment epithelium and the choriocapillaris . Trans Ophthalmol Soc U K . 1983;;103:444-447.
29 +
Lewis H, Schachat A, Haiman M, et al.  Choroidal neovascularization after laser photocoagulation for diabetic macular edema . Ophthalmology . 1990;;97:503-511.
30 +
Olk RJ.  Argon green (514 nm) versus krypton red (647 nm) modified grid laser photocoagulation for diffuse diabetic macular edema . Ophthalmology . 1990;;97:1101-1112.

First Page Preview

First page PDF preview

Figures

Tables

Interactive Graphics

Video

Country-Specific Mortality and Growth Failure in Infancy and Yound Children and Association With Material Stature

Use interactive graphics and maps to view and sort country-specific infant and early dhildhood mortality and growth failure data and their association with maternal

1 +
Wolbarsht MT, Landers MB.  The rationale of photocoagulation therapy for proliferative diabetic retinopathy: a review and model . Ophthalmic Surg . 1980;;11:235-245.
2 +
Tso MO, Cunha-Vaz JG, Shih C, Jones CW.  Clinicopathologic study of blood retinal barrier in experimental diabetes mellitus . Arch Ophthalmol . 1980;;98:2032-2040.
3 +
Glaser BM, Campochiaro PA, Davis JL, Jerdan JA.  Retinal pigment epithelial cells release inhibitors of neovascularization . Ophthalmology . 1987;;94:780-784.
4 +
Bresnick GH.  Diabetic maculopathy: a critical review highlighting diffuse macular edema . Ophthalmology . 1983;;90:1301-1317.
5 +
Wallow IH.  Repair of the pigment epithelial barrier following photocoagulation . Arch Ophthalmol . 1984;;102:126-135.
6 +
Gabel VP, Birngruber R, Hillenkamp F.  Visible and near infrared light absorption in pigment epithelium and choroid . In: Shimizu K, ed. International Congress Series No. 450, XXIII Concilium Ophthalmologicum, Kyoto . Princeton, NJ: Excerpta Medica; 1978;:658-662.
7 +
Anderson R, Parrish JA.  Selective photothermolysis . Science . 1983;;220:524-527.
8 +
Birngruber R, Hillenkamp F, Gabel VP.  Theoretical investigations of laser thermal retinal injury . Health Phys . 1985;;48:781-796.
9 +
Roider J, Birngruber R.  Spatial confinement of photocoagulation effects using high repetition rate laser pulses . In: Conference on Lasers and Electro-Optics, Technical Digest Series . Washington, DC: Optical Society of America; 1990;;7:168-169.
10 +
Marshall J.  Interactions between sensory cells, glia cells and the retinal pigment epithelium and their response to photocoagulation . Dev Ophthalmol . 1981;;2:308-317.
11 +
Pollack A, Korte GE.  Repair of retinal pigment epithelium and its relationship with capillary endothelium after krypton photocoagulation . Invest Ophthalmol Vis Sci . 1990;;31:890-898.
12 +
Wallow I.  Long term changes in photocoagulation burns . Dev Ophthalmol . 1981;;2:318-327.
13 +
Wallow IH, Tso MO.  Repair after xenon arc photocoagulation, II: a clinical and light microscopic study of the evolution of retinal lesions in the rhesus monkey . Am J Ophthalmol . 1973;;75:610-626.
14 +
Birngruber R, Gabel VP, Hillenkamp F.  Experimental studies of laser thermal retinal injury . Health Phys . 1983;;44:519-531.
15 +
Yanoff M, Fine BS. Ocular Pathology; A Text and Atlas . 2nd ed. New York, NY: Harper & Row Publishers Inc; 1982;:196-201.
16 +
Del Priore LV, Glaser BM, Quigley HA, Green R.  Response of pig retinal pigment epithelium to laser photocoagulation in organ culture . Arch Opthalmol . 1989;;107:119-122.
17 +
Hergott GJ, Sandig M, Kalnins VI.  Cytoskeletal organization of migrating retinal pigment epithelial cells during wound healing in organ culture . Cell Motil Cytoskeleton . 1989;;13:83-93.
18 +
Marshall J, Fankhauser F, Lotmar W, Roulier W.  Pathology of short pulse retinal photocoagulations using the Goldmann contact lens . Graefes Arch Clin Exp Ophthalmol . 1971;;182:154-169.
19 +
Bülow N.  The process of wound healing of the avascular outer layers of the retina, light- and electron-microscopic studies on laser lesions of monkey eyes . Acta Ophthalmol Suppl (Copenh) . 1978;;139:7-60.
20 +
Inomata H.  Wound healing after xenon arc photocoagulation in the rabbit retina . Ophthalmologica . 1975;;170:462-474.
21 +
Machemer R, Laqua H.  Pigment epithelium proliferation in retinal detachment (massive periretinal proliferation) . Am J Ophthalmol . 1975;;80:1-23.
22 +
Hergott GJ, Gallie B, Kalnins VI.  Proliferating cell nuclear antigen (PCNA) in migrating retinal pigment epithelial cells (RPE) during wound healing in organ culture . Invest Ophthalmol Vis Sci . 1991;;32:1219. Abstract.
23 +
Pollack A, Korte GE, Weitzner AL, Henkind P.  Ultrastructure of Bruch's membrane after krypton laser photocoagulation, I: breakdown of Bruch's membrane . Arch Ophthalmol . 1986;;104:1372-1375.
24 +
Marmor MF.  Control of subretinal fliud: experimental and clinical studies . Eye . 1990;;4:340-344.
25 +
Miller SS, Hughes BA, Machen TE.  Fluid transport across retinal pigment epithelium is inhibited by cyclic AMP . Proc Natl Acad Sci U S A . 1982;;79:2111-2115.
26 +
Zweig K, Cunha-Vaz J, Peyman G, Stein M, Raichand M.  Effect of argon laser photocoagulation on fluorescein transport across the blood retinal barrier . Exp Eye Res . 1981;;32:323-329.
27 +
Korte GE, Reppucci V, Henkind P.  RPE destruction causes choriocapillary atrophy . Invest Ophthalmol Vis Sci . 1984;;25:1135-1144.
28 +
Henkind P, Gartner S.  The relationship between retinal pigment epithelium and the choriocapillaris . Trans Ophthalmol Soc U K . 1983;;103:444-447.
29 +
Lewis H, Schachat A, Haiman M, et al.  Choroidal neovascularization after laser photocoagulation for diabetic macular edema . Ophthalmology . 1990;;97:503-511.
30 +
Olk RJ.  Argon green (514 nm) versus krypton red (647 nm) modified grid laser photocoagulation for diffuse diabetic macular edema . Ophthalmology . 1990;;97:1101-1112.

Correspondence

Submit a Letter
CME Course for:


You need to register in order to view this quiz.


To understand the clinical management of acute heart failure syndromes.
Accreditation Information The American Medical Association is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians.
The AMA designates this journal-based CME activity for a maximum of 1 AMA PRA Category 1 CreditTM per course. Physicians should claim only the credit commensurate with the extent of their participation in the activity.
Physicians who complete the CME course and score at least 80% correct on the quiz are eligible for AMA PRA Category 1 CreditTM.
Note: You must get at least of the answers correct to pass this quiz.
Note: You must get at least of the answers correct to pass this quiz.
You have not filled in all the answers to complete this quiz
The following questions were not answered:
Sorry, you have unsuccessfully completed this CME quiz with a score of
The following questions were not answered correctly:
For CME Course: A Proposed Model for Initial Assessment and Management of Acute Heart Failure Syndromes
Indicate what changes(s) you will implement in your practice, if any, based on this CME course.
To view and print your certificate and access a summary of your CME courses go to My CME.
NOTE:
Citing articles are presented as examples only. In non-demo SCM6 implementation, integration with CrossRef’s “Cited By” API will populate this tab (http://www.crossref.org/citedby.html).
Compression-Only CPR: Pushing the Science Forward
Cone
AAM 2010;304:1493-1495.
All you need to read in the other general journals
BMJ 2010;341:c5893-c1494.
Submit a Comment

Some tools below are only available to our subscribers or users with an online account.

Related Content

Customize your page view by dragging & repositioning the boxes below.

© 2012 American Medical Association. All Rights Reserved.
Powered bySilverchair Information Systems