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January 1995, Vol 113, No. 1 >
ARTICLE | January 1995

High-Resolution Magnetic Resonance Imaging Evaluation of Blood-Retinal Barrier Integrity Following Transscleral Diode Laser Treatment FREE

Everton L. Arrindell, MD; James C. Wu, PhD; Mitchell D. Wolf, MD; Sumit Nanda, MD; Dennis P. Han, MD; Eric C. Wong, PhD; Gary W. Abrams, MD; William F. Mieler, MD; James S. Hyde, PhD
Arch Ophthalmol. 1995;113(1):96-102. doi:10.1001/archopht.1995.01100010098027
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Objective:  To compare the effects of contact transscleral diode laser treatment and retinal cryotherapy on blood-retinal barrier integrity with the use of high-resolution magnetic resonance imaging techniques with constant infusion of gadolinium—diethylenetriaminepentaacetic acid (Gd-DTPA).

Methods:  Transscleral diode laser photocoagulation and retinal cryotherapy were used to treat equivalent areas of the inferior retinal periphery of pigmented rabbits. Magnetic resonance imaging time-course studies with measurement of signal enhancements due to Gd-DTPA leak-age were conducted 2 and 15 days following treatment.

Results:  Two days following treatment, cryotherapytreated eyes exhibited a mean (±SD) effective Gd-DTPA permeability coefficient of 4.6±0.8×10−6 cm/s; in comparison, diode laser—treated eyes exhibited 1.6×1.4×10−6 cm/s effective permeability. Significant decreases in the effective permeability were also noted 15 days after treatment in both groups.

Conclusions:  Transscleral contact probe diode laser photocoagulation induces less disruption of the blood-retinal barrier than does conventional cryotherapy. In addition, the continuous infusion method of Gd-DTPA delivery is a reliable and easily interpretable alternative to the commonly used bolus injection approach.

REFERENCES

1 +
Algvere PV, Hallnas K, Dafgard E, Hoog A.  Panretinal photocoagulation aggravates experimental proliferative vitreoretinopathy . Graefes Arch Clin Exp Ophthalmol . 1990;;228:461-466.
2 +
Campochiaro P, Jerdan J, Glaser BM.  Serum contains chemoattractants for human retinal pigment epithelial cells . Arch Ophthalmol . 1984;;102:1830-1833.
3 +
Campochiaro P, Jerdan J, Glaser B, Cardin A, Michels R.  Vitreous aspirates from patients with proliferative vitreoretinopathy stimulate retinal pigment epithelial cell migration . Arch Ophthalmol . 1985;;103:1403-1405.
4 +
Campochiaro P, Bryan J, Conway B, Jaccoma E.  Intravitreal chemotactic and mitogenic activity . Arch Ophthalmol . 1986;;104:1685-1687.
5 +
Jaccoma E, Conway B, Campochiaro P.  Cryotherapy causes extensive breakdown of the blood-retinal barrier . Arch Ophthalmol . 1985;;103:1728-1730.
6 +
Berkowitz BA, Sato Y, Wilson CA, de Juan E Jr.  Blood-retinal barrier breakdown investigated by real-time MRI following gadolinium-diethylenetriamine pentaacetic acid injection . Invest Ophthalmol Vis Sci . 1991;;32:2854-2860.
7 +
McHugh JDA, Marshall J, Capon M, Rothery S, Raven A, Naylor RP.  Transpupillary retinal photocoagulation in the eyes of rabbit and human using a diode laser . Lasers Ophthalmol . 1988;;2:125-143.
8 +
Brancato R, Pratesi R.  Applications of diode laser in ophthalmology . Lasers Light Ophthalmol . 1987;;1:119-129.
9 +
Brancato R, Pratesi R, Leoni G, Trabucchi G, Giovanni L, Vanni U.  Retinal photocoagulation with diode laser operating from a slit-lamp microscope . Lasers Light Ophthalmol . 1988;;2:73-78.
10 +
Peyman GA, Naguib KS, Gaasterland D.  Transscleral application of a Semiconductor diode laser . Laser Surg Med . 1990;;10:569-575.
11 +
Schenck JF, Hart HR, Foster TH, et al.  Improved MR imaging of the orbit at 1.5 T with surface coils . AJR Am J Roentgenol . 1985;;144:1033-1036.
12 +
Mafee MF, Peyman GA, Grislano JE, et al.  Malignant uveal melanoma and simulating lesions: MR imaging evaluation . Radiology . 1986;;160:773-789.
13 +
Zimmerman RA, Bilaniuk LT.  Ocular MR imaging . Radiology . 1988;;168:875-876.
14 +
Plehwe WE, McRobbie DW, Lerski RA, Kohner EM.  Quantitative magnetic resonance imaging in assessment of the blood-retinal barrier . Invest Ophthalmol Vis Sci . 1988;;29:663-670.
15 +
Wu JC, Jesmanowicz A, Hyde JS.  Anterior segment high resolution MRI: aqueous humor dynamics observed using contrast agents . Exp Eye Res . 1992;;54:145-148.
16 +
Wu JC, Wong EC, Arrindell EL, Simons KB, Jesmanowicz A, Hyde JS.  In vivo determination of anisotropic diffusion of water, T1 and T2 in rabbit lens by high resolution MRI . Invest Ophthalmol Vis Sci . 1993;;34:2151-2158.
17 +
Wong EC, Jesmanowicz A, Hyde JS.  High-resolution, short echo time MR imaging of the fingers and wrist with a local gradient coil . Radiology . 1991;;181:393-397.
18 +
Wedeking P, Eaton S, Covell DG, Nair S, Tweedle MF, Eckelman WC.  Pharmacokinetic analysis of blood distribution of intravenously administered 153Gdlabeled Gd(DTPA)−2 and 99mTc(DTPA) in rats . Magn Reson Imaging . 1990;;8:567-575.
19 +
Brancato R, Pratesi R, Leoni G, Trabucchi G, Vanni U.  Histopathology of diode and argon laser lesions in rabbit retina . Invest Ophthalmol Vis Sci . 1989;;30:1504-1510.
20 +
Hahn EL.  Spin echoes . Physiol Rev . 1950;;80:580-594.
21 +
Bloembergen N, Purcell EM, Pound RV.  Relaxation effects in nuclear magnetic resonance absorption . Physiol Rev . 1948;;73:679-712.
22 +
Gadian DG, Payne JA, Bryant DJ, Young IR, Carr DH, Bydder GM.  Gadolinium-DTPA as a contrast agent in MR imaging: theoretical projections and practical observations . J Comput Assist Tomogr . 1985;;9:242-251.
23 +
Solomon I.  Relaxation process in a system of two spins . Physiol Rev . 1955;;99:559-565.
24 +
Notari RE. Biopharmaceutics and Clinical Pharmacokinetics . 3rd ed. New York, NY: Marcel Dekker Inc; 1980;.
25 +
Sen HA, Robertson TJ, Conway BP, Campochiaro PA.  The role of breakdown of the blood-retinal barrier in cell-injection models of proliferative vitreoretinopathy . Arch Ophthalmol . 1988;;106:1291-1294.
26 +
Rodrigues MM, Newsome DA, Machemer R.  Further characterization of epiretinal membranes in human massive periretinal proliferation . Curr Eye Res . 1981;;6:311-315.
27 +
Vinores SA, Campochiaro PA, Conway BP.  Ultrastructural and electronimmunocytochemical characterization of cells in epiretinal membranes . Invest Ophthalmol Vis Sci . 1990;;31:14-28.
28 +
Guerin CJ, Wolfshagen RW, Eifrig DE, Anderson DH.  Immunocytochemical identification of Mueller's glia as a component of human epiretinal membranes . Invest Ophthalmol Vis Sci . 1990;;31:1483-1491.
29 +
Cleary PE, Ryan SJ.  Method of production and natural history of experimental posterior penetrating eye injury in the rhesus monkey . Am J Ophthalmol . 1975;;80:1-23.
30 +
Mainster MA.  Wavelength selection in macular photocoagulation: tissue optics, thermal effects, and laser systems . Ophthalmology . 1986;;93:952-958.
31 +
Smiddy WE, Hernandez E.  Histopathologic results of retinal diode laser photocoagulation in rabbit eyes . Arch Ophthalmol . 1992;;110:693-698.
32 +
Smiddy WE, Hernandez E.  Histopathologic characteristics of diode laser-induced chorioretinal adhesions for experimental retinal detachment in rabbit eyes . Arch Ophthalmol . 1992;;110:1630-1633.
33 +
Sato Y, Berkowicz BA, Wilson CA, de Juan E Jr.  Blood-retinal barrier breakdown caused by diode vs argon laser endophotocoagulation . Arch Ophthalmol . 1992;;110:277-281.
34 +
Jennings T, Joondeph BC, Fuller T, et al.  Transscleral contact retinal photocoagulation with an 810-nm semiconductor diode laser . Ophthalmic Surg . 1990;;21:492-496.
35 +
Cryotherapy for Retinopathy of Prematurity Cooperative Group.  Multicenter trial of cryotherapy for retinopathy of prematurity: preliminary results . Arch Ophthalmol . 1988;;106:471-479.

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1 +
Algvere PV, Hallnas K, Dafgard E, Hoog A.  Panretinal photocoagulation aggravates experimental proliferative vitreoretinopathy . Graefes Arch Clin Exp Ophthalmol . 1990;;228:461-466.
2 +
Campochiaro P, Jerdan J, Glaser BM.  Serum contains chemoattractants for human retinal pigment epithelial cells . Arch Ophthalmol . 1984;;102:1830-1833.
3 +
Campochiaro P, Jerdan J, Glaser B, Cardin A, Michels R.  Vitreous aspirates from patients with proliferative vitreoretinopathy stimulate retinal pigment epithelial cell migration . Arch Ophthalmol . 1985;;103:1403-1405.
4 +
Campochiaro P, Bryan J, Conway B, Jaccoma E.  Intravitreal chemotactic and mitogenic activity . Arch Ophthalmol . 1986;;104:1685-1687.
5 +
Jaccoma E, Conway B, Campochiaro P.  Cryotherapy causes extensive breakdown of the blood-retinal barrier . Arch Ophthalmol . 1985;;103:1728-1730.
6 +
Berkowitz BA, Sato Y, Wilson CA, de Juan E Jr.  Blood-retinal barrier breakdown investigated by real-time MRI following gadolinium-diethylenetriamine pentaacetic acid injection . Invest Ophthalmol Vis Sci . 1991;;32:2854-2860.
7 +
McHugh JDA, Marshall J, Capon M, Rothery S, Raven A, Naylor RP.  Transpupillary retinal photocoagulation in the eyes of rabbit and human using a diode laser . Lasers Ophthalmol . 1988;;2:125-143.
8 +
Brancato R, Pratesi R.  Applications of diode laser in ophthalmology . Lasers Light Ophthalmol . 1987;;1:119-129.
9 +
Brancato R, Pratesi R, Leoni G, Trabucchi G, Giovanni L, Vanni U.  Retinal photocoagulation with diode laser operating from a slit-lamp microscope . Lasers Light Ophthalmol . 1988;;2:73-78.
10 +
Peyman GA, Naguib KS, Gaasterland D.  Transscleral application of a Semiconductor diode laser . Laser Surg Med . 1990;;10:569-575.
11 +
Schenck JF, Hart HR, Foster TH, et al.  Improved MR imaging of the orbit at 1.5 T with surface coils . AJR Am J Roentgenol . 1985;;144:1033-1036.
12 +
Mafee MF, Peyman GA, Grislano JE, et al.  Malignant uveal melanoma and simulating lesions: MR imaging evaluation . Radiology . 1986;;160:773-789.
13 +
Zimmerman RA, Bilaniuk LT.  Ocular MR imaging . Radiology . 1988;;168:875-876.
14 +
Plehwe WE, McRobbie DW, Lerski RA, Kohner EM.  Quantitative magnetic resonance imaging in assessment of the blood-retinal barrier . Invest Ophthalmol Vis Sci . 1988;;29:663-670.
15 +
Wu JC, Jesmanowicz A, Hyde JS.  Anterior segment high resolution MRI: aqueous humor dynamics observed using contrast agents . Exp Eye Res . 1992;;54:145-148.
16 +
Wu JC, Wong EC, Arrindell EL, Simons KB, Jesmanowicz A, Hyde JS.  In vivo determination of anisotropic diffusion of water, T1 and T2 in rabbit lens by high resolution MRI . Invest Ophthalmol Vis Sci . 1993;;34:2151-2158.
17 +
Wong EC, Jesmanowicz A, Hyde JS.  High-resolution, short echo time MR imaging of the fingers and wrist with a local gradient coil . Radiology . 1991;;181:393-397.
18 +
Wedeking P, Eaton S, Covell DG, Nair S, Tweedle MF, Eckelman WC.  Pharmacokinetic analysis of blood distribution of intravenously administered 153Gdlabeled Gd(DTPA)−2 and 99mTc(DTPA) in rats . Magn Reson Imaging . 1990;;8:567-575.
19 +
Brancato R, Pratesi R, Leoni G, Trabucchi G, Vanni U.  Histopathology of diode and argon laser lesions in rabbit retina . Invest Ophthalmol Vis Sci . 1989;;30:1504-1510.
20 +
Hahn EL.  Spin echoes . Physiol Rev . 1950;;80:580-594.
21 +
Bloembergen N, Purcell EM, Pound RV.  Relaxation effects in nuclear magnetic resonance absorption . Physiol Rev . 1948;;73:679-712.
22 +
Gadian DG, Payne JA, Bryant DJ, Young IR, Carr DH, Bydder GM.  Gadolinium-DTPA as a contrast agent in MR imaging: theoretical projections and practical observations . J Comput Assist Tomogr . 1985;;9:242-251.
23 +
Solomon I.  Relaxation process in a system of two spins . Physiol Rev . 1955;;99:559-565.
24 +
Notari RE. Biopharmaceutics and Clinical Pharmacokinetics . 3rd ed. New York, NY: Marcel Dekker Inc; 1980;.
25 +
Sen HA, Robertson TJ, Conway BP, Campochiaro PA.  The role of breakdown of the blood-retinal barrier in cell-injection models of proliferative vitreoretinopathy . Arch Ophthalmol . 1988;;106:1291-1294.
26 +
Rodrigues MM, Newsome DA, Machemer R.  Further characterization of epiretinal membranes in human massive periretinal proliferation . Curr Eye Res . 1981;;6:311-315.
27 +
Vinores SA, Campochiaro PA, Conway BP.  Ultrastructural and electronimmunocytochemical characterization of cells in epiretinal membranes . Invest Ophthalmol Vis Sci . 1990;;31:14-28.
28 +
Guerin CJ, Wolfshagen RW, Eifrig DE, Anderson DH.  Immunocytochemical identification of Mueller's glia as a component of human epiretinal membranes . Invest Ophthalmol Vis Sci . 1990;;31:1483-1491.
29 +
Cleary PE, Ryan SJ.  Method of production and natural history of experimental posterior penetrating eye injury in the rhesus monkey . Am J Ophthalmol . 1975;;80:1-23.
30 +
Mainster MA.  Wavelength selection in macular photocoagulation: tissue optics, thermal effects, and laser systems . Ophthalmology . 1986;;93:952-958.
31 +
Smiddy WE, Hernandez E.  Histopathologic results of retinal diode laser photocoagulation in rabbit eyes . Arch Ophthalmol . 1992;;110:693-698.
32 +
Smiddy WE, Hernandez E.  Histopathologic characteristics of diode laser-induced chorioretinal adhesions for experimental retinal detachment in rabbit eyes . Arch Ophthalmol . 1992;;110:1630-1633.
33 +
Sato Y, Berkowicz BA, Wilson CA, de Juan E Jr.  Blood-retinal barrier breakdown caused by diode vs argon laser endophotocoagulation . Arch Ophthalmol . 1992;;110:277-281.
34 +
Jennings T, Joondeph BC, Fuller T, et al.  Transscleral contact retinal photocoagulation with an 810-nm semiconductor diode laser . Ophthalmic Surg . 1990;;21:492-496.
35 +
Cryotherapy for Retinopathy of Prematurity Cooperative Group.  Multicenter trial of cryotherapy for retinopathy of prematurity: preliminary results . Arch Ophthalmol . 1988;;106:471-479.

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