Macular injury by an Nd:YAG rangefinder

Johann Roider M.D.; Patrick Buesgen; Hans Hoerauf; Horst Laqua; Reginald Birngruber

doi:10.1117/12.350602

18 June 1999 Macular injury by an Nd:YAG rangefinder

Johann Roider M.D., Patrick Buesgen, Hans Hoerauf, Horst Laqua, Reginald Birngruber

Proceedings Volume 3591, Ophthalmic Technologies IX; (1999) https://doi.org/10.1117/12.350602
Event: BiOS '99 International Biomedical Optics Symposium, 1999, San Jose, CA, United States

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.

Citation Download Citation

Johann Roider M.D., Patrick Buesgen, Hans Hoerauf, Horst Laqua, and Reginald Birngruber "Macular injury by an Nd:YAG rangefinder", Proc. SPIE 3591, Ophthalmic Technologies IX, (18 June 1999); https://doi.org/10.1117/12.350602

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KEYWORDS

Laser therapeutics

Injuries

Laser tissue interaction

Nd:YAG lasers

Angiography

Blood

Visualization

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