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Neodymium-YAG Laser Vitreolysis in Sickle Cell Retinopathy

Neodymium-YAG Laser Vitreolysis in Sickle Cell Retinopathy Abstract • Six patients with proliferative sickle cell retinopathy and vitreous bands were treated with the neodymium-YAG (Nd-YAG) laser to accomplish lysis of avascular traction bands or to clear the media in front of the macula. Transection of bands was possible in five of the six cases but in two of these the effect was only partial. Three cases were satisfactorily treated with the Nd-YAG laser application alone, two eventually required conventional vitreoretinal surgery, and one patient's condition stabilized despite failure of the treatment. Complications from the treatment occurred in three cases and included subretinal (choroidal) hemorrhage, preretinal hemorrhage, microperforation of a retinal vein, and focal areas of damage to the retinal pigment epithelium. Neodymium-YAG vitreolysis may be a useful modality in carefully selected patients with proliferative sickle cell retinopathy, but potentially sight-threatening complications may occur. References 1. Goldberg MF, Jampol LM: Treatment of neovascularization, vitreous hemorrhage, and retinal detachment in sickle cell retinopathy , in Symposium on Medical and Surgical Diseases of the Retina and Vitreous: Transactions of the New Orleans Academy of Ophthalmology . St Louis, CV Mosby Co, 1983, pp 53-81. 2. Jampol LM, Condon P, Farber M, et al: A randomized clinical trial of feeder vessel photocoagulation of proliferative sickle cell retinopathy . Ophthalmology 1983;90:540-545.Crossref 3. Jampol LM, Goldberg MF, Jednock N: Retinal damage from a Q-switched YAG laser . Am J Ophthalmol 1983;96:326-329. 4. Rednam KRV, Jampol LM, Goldberg MF: Scatter retinal photocoagulation for proliferative sickle cell retinopathy . Am J Ophthalmol 1982;93:594-599. 5. Goldberg MF: Natural history of untreated proliferative sickle retinopathy . Am J Ophthalmol 1971;85:428-437. 6. Condon PI, Serjeant GR: Behaviour of untreated proliferative sickle retinopathy . Br J Ophthalmol 1980;64:404-411.Crossref 7. Nagpal KC, Patrianakos D, Asdourian GK, et al: Spontaneous regression (autoinfarction) of proliferative sickle retinopathy . Am J Ophthalmol 1975;80:885-892. 8. Jampol LM, Goldberg MF: Retinal breaks after photocoagulation of proliferative sickle cell retinopathy . Arch Ophthalmol 1980;98:676-679.Crossref 9. Raichand M, Dizon RV, Nagpal KC, et al: Macular holes associated with proliferative sickle cell retinopathy . Arch Ophthalmol 1978;96:1592-1596.Crossref 10. Dizon-Moore RV, Jampol LM, Goldberg MF: Chorioretinal and choriovitreal neovascularization: Their presence after photocoagulation of proliferative sickle cell retinopathy . Arch Ophthalmol 1981;99:842-849.Crossref 11. Ryan SJ: Role of the vitreous in the hemoglobinopathies . Trans Ophthalmol Soc UK 1975;95:403-406. 12. Ryan SJ, Goldberg MF: Anterior segment ischemia following scleral buckling in sickle cell hemoglobinopathy . Am J Ophthalmol 1971;72:35-50. 13. Jampol LM, Green JL, Goldberg MF, et al: An update on vitrectomy surgery and retinal detachment repair in sickle cell disease . Arch Ophthalmol 1982;100:591-593.Crossref 14. Wilhelm JL, Zakov ZN, Holtge GA: Erythrophoresis in treating retinal detachment secondary to sickle cell retinopathy . Am J Ophthalmol 1981;92:582-583. 15. Goldbaum MH, Peyman GA, Nagpal KC, et al: Vitrectomy in sickling retinopathy: Report of five cases . Ophthalmic Surg 1976;7:92-102. 16. Goldberg MF: Sickled erythrocytes, hyphema and secondary glaucoma: I. The diagnosis and treatment of sickled erythrocytes in human hyphemas . Ophthalmic Surg 1979;10:17-31. 17. Goldberg MF: The diagnosis and treatment of secondary glaucoma after hyphema in sickle cell patients . Am J Ophthalmol 1979;87:43-49. 18. Brown GC, Benson WE: Treatment of diabetic traction retinal detachment with the pulsed neodymium-YAG laser . Am J Ophthalmol 1985;99:258-262. 19. 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.Crossref 20. Bonner RF, Meyers SM, Gaasterland DE: Threshold for retinal damage associated with the use of high-power neodymium-YAG lasers in the vitreous . Am J Ophthalmol 1983;96:153-159. 21. Aron-Rosa D, Greenspan DA: Neodymium:YAG laser vitreolysis . Int Ophthalmol Clin 1985;25:125-134.Crossref 22. Puliafito KA, Wasson PJ, Steinert RF: Neodymium-YAG laser surgery on experimental vitreous membranes . Arch Ophthalmol 1984;102:843-847.Crossref 23. Brown GC, Scimeca G, Shields JA: Effects of the pulsed neodymium:YAG laser on the posterior segment . Ophthalmic Surg 1986;17:470-473. 24. Fankhauser F, Kwasniewski SF, van der Zypen E: Vitreolysis with the Q-switched laser . Arch Ophthalmol 1985;103:1166-1171.Crossref http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Archives of Ophthalmology American Medical Association

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References (29)

Publisher
American Medical Association
Copyright
Copyright © 1987 American Medical Association. All Rights Reserved.
ISSN
0003-9950
eISSN
1538-3687
DOI
10.1001/archopht.1987.01060080089034
Publisher site
See Article on Publisher Site

Abstract

Abstract • Six patients with proliferative sickle cell retinopathy and vitreous bands were treated with the neodymium-YAG (Nd-YAG) laser to accomplish lysis of avascular traction bands or to clear the media in front of the macula. Transection of bands was possible in five of the six cases but in two of these the effect was only partial. Three cases were satisfactorily treated with the Nd-YAG laser application alone, two eventually required conventional vitreoretinal surgery, and one patient's condition stabilized despite failure of the treatment. Complications from the treatment occurred in three cases and included subretinal (choroidal) hemorrhage, preretinal hemorrhage, microperforation of a retinal vein, and focal areas of damage to the retinal pigment epithelium. Neodymium-YAG vitreolysis may be a useful modality in carefully selected patients with proliferative sickle cell retinopathy, but potentially sight-threatening complications may occur. References 1. Goldberg MF, Jampol LM: Treatment of neovascularization, vitreous hemorrhage, and retinal detachment in sickle cell retinopathy , in Symposium on Medical and Surgical Diseases of the Retina and Vitreous: Transactions of the New Orleans Academy of Ophthalmology . St Louis, CV Mosby Co, 1983, pp 53-81. 2. Jampol LM, Condon P, Farber M, et al: A randomized clinical trial of feeder vessel photocoagulation of proliferative sickle cell retinopathy . Ophthalmology 1983;90:540-545.Crossref 3. Jampol LM, Goldberg MF, Jednock N: Retinal damage from a Q-switched YAG laser . Am J Ophthalmol 1983;96:326-329. 4. Rednam KRV, Jampol LM, Goldberg MF: Scatter retinal photocoagulation for proliferative sickle cell retinopathy . Am J Ophthalmol 1982;93:594-599. 5. Goldberg MF: Natural history of untreated proliferative sickle retinopathy . Am J Ophthalmol 1971;85:428-437. 6. Condon PI, Serjeant GR: Behaviour of untreated proliferative sickle retinopathy . Br J Ophthalmol 1980;64:404-411.Crossref 7. Nagpal KC, Patrianakos D, Asdourian GK, et al: Spontaneous regression (autoinfarction) of proliferative sickle retinopathy . Am J Ophthalmol 1975;80:885-892. 8. Jampol LM, Goldberg MF: Retinal breaks after photocoagulation of proliferative sickle cell retinopathy . Arch Ophthalmol 1980;98:676-679.Crossref 9. Raichand M, Dizon RV, Nagpal KC, et al: Macular holes associated with proliferative sickle cell retinopathy . Arch Ophthalmol 1978;96:1592-1596.Crossref 10. Dizon-Moore RV, Jampol LM, Goldberg MF: Chorioretinal and choriovitreal neovascularization: Their presence after photocoagulation of proliferative sickle cell retinopathy . Arch Ophthalmol 1981;99:842-849.Crossref 11. Ryan SJ: Role of the vitreous in the hemoglobinopathies . Trans Ophthalmol Soc UK 1975;95:403-406. 12. Ryan SJ, Goldberg MF: Anterior segment ischemia following scleral buckling in sickle cell hemoglobinopathy . Am J Ophthalmol 1971;72:35-50. 13. Jampol LM, Green JL, Goldberg MF, et al: An update on vitrectomy surgery and retinal detachment repair in sickle cell disease . Arch Ophthalmol 1982;100:591-593.Crossref 14. Wilhelm JL, Zakov ZN, Holtge GA: Erythrophoresis in treating retinal detachment secondary to sickle cell retinopathy . Am J Ophthalmol 1981;92:582-583. 15. Goldbaum MH, Peyman GA, Nagpal KC, et al: Vitrectomy in sickling retinopathy: Report of five cases . Ophthalmic Surg 1976;7:92-102. 16. Goldberg MF: Sickled erythrocytes, hyphema and secondary glaucoma: I. The diagnosis and treatment of sickled erythrocytes in human hyphemas . Ophthalmic Surg 1979;10:17-31. 17. Goldberg MF: The diagnosis and treatment of secondary glaucoma after hyphema in sickle cell patients . Am J Ophthalmol 1979;87:43-49. 18. Brown GC, Benson WE: Treatment of diabetic traction retinal detachment with the pulsed neodymium-YAG laser . Am J Ophthalmol 1985;99:258-262. 19. 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.Crossref 20. Bonner RF, Meyers SM, Gaasterland DE: Threshold for retinal damage associated with the use of high-power neodymium-YAG lasers in the vitreous . Am J Ophthalmol 1983;96:153-159. 21. Aron-Rosa D, Greenspan DA: Neodymium:YAG laser vitreolysis . Int Ophthalmol Clin 1985;25:125-134.Crossref 22. Puliafito KA, Wasson PJ, Steinert RF: Neodymium-YAG laser surgery on experimental vitreous membranes . Arch Ophthalmol 1984;102:843-847.Crossref 23. Brown GC, Scimeca G, Shields JA: Effects of the pulsed neodymium:YAG laser on the posterior segment . Ophthalmic Surg 1986;17:470-473. 24. Fankhauser F, Kwasniewski SF, van der Zypen E: Vitreolysis with the Q-switched laser . Arch Ophthalmol 1985;103:1166-1171.Crossref

Journal

Archives of OphthalmologyAmerican Medical Association

Published: Aug 1, 1987

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