Laser diodo vermelho com oftalmoscopia indireta no tratamento da retinopatia diabética proliferativa

Sotto-Maior, Maria Cândida; Farah, Michel Eid; Uno, Fausto

doi:10.5935/0004-2749.19980097

RESUMO

Objetivo:

Analisar a técnica, indicações e resultados da fotocoagulação com laser diodo vermelho com oftalmoscopia indireta em portadores de Retinopatia Diabética Proliferativa.

Pacientes e Métodos:

Estudo prospectivo da fotocoagulação com laser diodo vermelho (810 nm) indireto em 28 olhos de 21 pacientes com RDP com ou sem limitações técnicas para o tratamento à lâmpada de fenda.

Resultados:

Treze olhos (46%) completaram o tratamento e apresentaram estabilidade, com melhora da proliferação. Quinze olhos (54%) tiveram seu tratamento interrompido por intercorrências como evolução de catarata, hemorragia vítrea clinicamente significativa, alterações sistêmicas (como hipertensão arterial não controlada e cardiopatia que limitavam o uso do bloqueio anestésico) e alguns por dor intolerável, mesmo após bloqueio peribulbar.

Conclusão:

A técnica de laser diodo com oftalmoscopia indireta tem papel importante no tratamento da retinopatia diabética quando a panfotocoagulação deve ser realizada na periferia retiniana em olhos que possuem opacidades de meios. O laser diodo vermelho foi eficaz nos pacientes que completaram o tratamento.

Palavras-chave:
Fotocoagulação; Laser diodo; Oftalmoscopia indireta; Retinopatia diabética

SUMMARY

Purpose:

To evaluate the technique, indications and results of the photocoagulation in Proliferative Diabetic Retinopathy using infrared diode laser with indirect ophthalmoscopy.

Patients and Methods:

Twenty one patients with or without restrictions to the photocoagulation on the slit-lamp were treated with the indirect infrared (81 0 nm) diode laser.

Results:

Thirteen patients have completed the treatment and presented stability or improvement of the proliferation. Fifteen eyes have interrupted the treatment due to intolerable pain, system a/terations, worsening of the cataract or vitreous hemorrhage.

Conclusions:

The indirect infrared diode laser is important for the treatment of Diabetic Retinophaty when it demands photocoagulation of the retina / periphery in eyes with media opacities. The infrared diode laser was effective to control the PDR when the patients have completed the treatment.

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REFERÊNCIAS BIBLIOGRÁFICAS

¹
Benson WE, Tasman W. Treatment of nonproliferative diabetic retinopathy. Clinical Decisions in Clinical Medical Diseases 1994; Cap 9, pp 152-61.
²
Diabetic Retinopathy Group. Photocoagulation of proliferative diabetic retinopathy study findings. Ophthalmology 1978;85:82-102.
³
Diabetic Retinopathy Study Research Group. Photocoagulation treatment of proliferative diabetic retinopathy: clinical application of diabetic retinopathy study (DRS) findings. DRS report number 8. Ophthalmology 1981;88:583-660.
⁴
Obana A, Lorenz B, Gassier A, Birngruber R. The therapeutic range of chorioretinal photocoagulation with diode and argon lasers: an experimental comparison. Lasers and Light in Ophthalmology 1992;4:147-56.
⁵
Mizuno K. Binocular indirect argon laser photocoagulator. British Journal of Ophthalmology 1981;65:425-8.
⁶
Bloom SM, Murphy SF, Brier ME. Laser indirect ophthalmoscope photocoagulation and scleral depression for rhegmatogenous retinal detachment. Retina 1995;15:224-32.
⁷
Smiddy WE, Hernandez E. Histopathologic results of retinal diode laser photocoagulation in rabbit eyes. Archives of Ophthalmology 1992;110:693-98.
⁸
Gonçalves JCM. Laser de diodo. Arquivos Brasileiros de Oftalmologia 1996; 59:103-4.
⁹
Mchugh JDA e col. Initial clinical experience using a diode laser in the treatment of retinal vascular disease. Eye 1989;3:516-27.
¹⁰
Zahl K. Regional anesthesia for intraocular surgery. Ophthalmology Clinics of North America, cap l, 1990. pp 1-11.
¹¹
Schulenburg WE, Hamilton AM, Blach RK. A comparative study of argon laser and krypton laser in the treatment of diabetic optic disc neovas-cularisation. British Journal of Ophthalmology 1979;63:412-7.
¹²
Vander JF, Duker JS, Benson WE, Brown GC, McNamara JA, Rosenstein RB. Long-term stability and visual outcome after favorable initial response of proliferative diabetic retinopathy to panretinal photocoagulation, 1991;98:1575-9.

Datas de Publicação

Publicação nesta coleção
Feb 1998

Este é um artigo publicado em acesso aberto (Open Access) sob a licença Creative Commons Attribution, que permite uso, distribuição e reprodução em qualquer meio, sem restrições desde que o trabalho original seja corretamente citado.

[1] ¹
Benson WE, Tasman W. Treatment of nonproliferative diabetic retinopathy. Clinical Decisions in Clinical Medical Diseases 1994; Cap 9, pp 152-61.

[2] ²
Diabetic Retinopathy Group. Photocoagulation of proliferative diabetic retinopathy study findings. Ophthalmology 1978;85:82-102.

[3] ³
Diabetic Retinopathy Study Research Group. Photocoagulation treatment of proliferative diabetic retinopathy: clinical application of diabetic retinopathy study (DRS) findings. DRS report number 8. Ophthalmology 1981;88:583-660.

[4] ⁴
Obana A, Lorenz B, Gassier A, Birngruber R. The therapeutic range of chorioretinal photocoagulation with diode and argon lasers: an experimental comparison. Lasers and Light in Ophthalmology 1992;4:147-56.

[5] ⁵
Mizuno K. Binocular indirect argon laser photocoagulator. British Journal of Ophthalmology 1981;65:425-8.

[6] ⁶
Bloom SM, Murphy SF, Brier ME. Laser indirect ophthalmoscope photocoagulation and scleral depression for rhegmatogenous retinal detachment. Retina 1995;15:224-32.

[7] ⁷
Smiddy WE, Hernandez E. Histopathologic results of retinal diode laser photocoagulation in rabbit eyes. Archives of Ophthalmology 1992;110:693-98.

[8] ⁸
Gonçalves JCM. Laser de diodo. Arquivos Brasileiros de Oftalmologia 1996; 59:103-4.

[9] ⁹
Mchugh JDA e col. Initial clinical experience using a diode laser in the treatment of retinal vascular disease. Eye 1989;3:516-27.

[10] ¹⁰
Zahl K. Regional anesthesia for intraocular surgery. Ophthalmology Clinics of North America, cap l, 1990. pp 1-11.

[11] ¹¹
Schulenburg WE, Hamilton AM, Blach RK. A comparative study of argon laser and krypton laser in the treatment of diabetic optic disc neovas-cularisation. British Journal of Ophthalmology 1979;63:412-7.

[12] ¹²
Vander JF, Duker JS, Benson WE, Brown GC, McNamara JA, Rosenstein RB. Long-term stability and visual outcome after favorable initial response of proliferative diabetic retinopathy to panretinal photocoagulation, 1991;98:1575-9.

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