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Proceedings Paper

Macular injury by an Nd:YAG rangefinder
Author(s): Johann Roider M.D.; Patrick Buesgen; Hans Hoerauf; Horst Laqua; Reginald Birngruber
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Paper Abstract

The authors report the clinical findings of a civilian patient who unintentionally looked into the laser beam of a British range finder, obtained on the black market. The patient was investigated by fluorescein angiography. Indocyanine green angiography (ICG) and microperimetry both in the acute stage (2 hours) and four weeks later. Hundred mg prednisone tapered over 9 days was prescribed. Additionally 50 μg tissue plasminogen activator (TPA) and 0.5 ml pure C2F6 were injected in the vitreous. In the acute phase hemorrhage was located beneath the retina, primarily beneath the retinal pigment epithelium. Retinal defects as seen initially over the subretinal blood, were reduced after four weeks, but a retinal defect ranging from the lasered site towards the fovea remained. Visual acuity slightly increased from 20/100 to 20/63. ICG showed a large hypofluorescent spot in the macula. The technical parameters of the range finder were: Nd:YAG laser (1064 nm), pulse duration 10 ns, beam divergence 1.5 mrad, energy 10 mJ. A range finder can produce severe macular injury. The primary laser tissue interaction mechanism seems to be explosive disruption of choroidal tissue. Intravitral injection of TPA and C2F6 may be an adjunct in the therapy of acute laser lesions. A late complication can be secondary choroidal neovascularization.

Paper Details

Date Published: 18 June 1999
PDF: 6 pages
Proc. SPIE 3591, Ophthalmic Technologies IX, (18 June 1999); doi: 10.1117/12.350602
Show Author Affiliations
Johann Roider M.D., Univ. of Regensburg (Germany)
Patrick Buesgen, Univ. of Luebeck (Germany)
Hans Hoerauf, Univ. of Luebeck (Germany)
Horst Laqua, Univ. of Luebeck (Germany)
Reginald Birngruber, Medical Laser Center Luebeck (Germany)

Published in SPIE Proceedings Vol. 3591:
Ophthalmic Technologies IX
Bruce E. Stuck; Pascal O. Rol; Michael Belkin M.D.; Karen Margaret Joos M.D.; Fabrice Manns; Bruce E. Stuck; Michael Belkin M.D., Editor(s)

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