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Assessment of Vitreous Structure and Visual Function after Neodymium:Yttrium–Aluminum–Garnet Laser Vitreolysis
摘要： Purpose: Neodymium:yttriumealuminumegarnet (Nd:YAG) laser treatment is performed on vitreous ?oaters, but studies of structural and functional effects with objective outcome measures are lacking. This study evaluated Nd:YAG laser effects by comparing participants with vitreous ?oaters who previously underwent laser treatment with untreated control participants and healthy persons without vitreous ?oaters using quantitative ultrasonography to evaluate vitreous structure and by measuring visual acuity and contrast sensitivity function to assess vision. Design: Retrospective, comparative study. Participants: One eye was enrolled for each of 132 participants: 35 control participants without vitreous ?oaters, 59 participants with untreated vitreous ?oaters, and 38 participants with vitreous ?oaters previously Nd:YAG-treated. Of these, 25 were dissatis?ed and sought vitrectomy; 13 were satis?ed with observation. Methods: The 39-item National Eye Institute Visual Function Questionnaire (NEI-VFQ-39) to assess participant visual well-being, quantitative ultrasonography (QUS) to measure vitreous echodensity, and best-corrected visual acuity (BCVA) and contrast sensitivity function (CSF) to evaluate vision. Main Outcome Measures: Results of NEI-VFQ-39, QUS, BCVA, and CSF. Results: Compared with control participants without vitreous ?oaters, participants with untreated vitreous ?oaters showed worse NEI-VFQ-39 results, 57% greater vitreous echodensity, and signi?cant (130%) CSF degradation (P < 0.001 for each). Compared with untreated eyes with vitreous ?oaters, Nd:YAG-treated eyes had 23% less vitreous echodensity (P < 0.001), but no differences in NEI-VFQ-39 (P ? 0.51), BCVA (P ? 0.42), and CSF (P ? 0.17) results. Of 38 participants with vitreous ?oaters who previously were treated with Nd:YAG, 25 were dissatis?ed and seeking vitrectomy, whereas 13 were satis?ed with observation. Participants seeking vitrectomy showed 24% greater vitreous echodensity (P ? 0.018) and 52% worse CSF (P ? 0.006). Multivariate linear regression models con?rmed these ?ndings. Conclusions: As a group, participants previously treated with Nd:YAG laser for bothersome vitreous ?oaters showed less dense vitreous, but similar visual function as untreated control participants with vitreous ?oaters. Because some treated eyes showed less dense vitreous and better visual function than those of untreated control participants, a prospective randomized study of Nd:YAG laser treatment of vitreous is warranted, using uniform laser treatment parameters and objective quantitative outcome measures.
关键词： Neodymium:yttriumealuminumegarnet (Nd:YAG) laser,vitreous ?oaters,best-corrected visual acuity,quantitative ultrasonography,contrast sensitivity function
更新于2025-09-12 10:27:22
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A DOUBLE-MASKED, RANDOMIZED, SHAM-CONTROLLED, SINGLE-CENTER STUDY WITH PHOTOBIOMODULATION FOR THE TREATMENT OF DRY AGE-RELATED MACULAR DEGENERATION
摘要： The LIGHTSITE I study investigated the efficacy and safety of photobiomodulation (PBM) treatment in subjects with dry age-related macular degeneration. Thirty subjects (46 eyes) were treated with the Valeda Light Delivery System, wherein subjects underwent two series of treatments (3· per week for 3–4 weeks) over 1 year. Outcome measures included best-corrected visual acuity, contrast sensitivity, microperimetry, central drusen volume and drusen thickness, and quality of life assessments. Photobiomodulation-treated subjects showed a best-corrected visual acuity mean letter score gain of 4 letters immediately after each treatment series at Month 1 (M1) and Month 7 (M7). Approximately 50% of PBM-treated subjects showed improvement of $5 letters versus 13.6% in sham-treated subjects at M1. High responding subjects ($5-letter improvement) in the PBM-treated group showed a gain of 8 letters after initial treatment (P , 0.01) and exhibited earlier stages of age-related macular degeneration disease. Statistically significant improvements in contrast sensitivity, central drusen volume, central drusen thickness, and quality of life were observed (P , 0.05). No device-related adverse events were reported. Photobiomodulation treatment statistically improved clinical and anatomical outcomes with more robust benefits observed in subjects with earlier stages of dry age-related macular degeneration. Repeated PBM treatments are necessary to maintain benefits. These pilot findings support previous reports and suggest the utility of PBM as a safe and effective therapy in subjects with dry age-related macular degeneration.
关键词： contrast sensitivity,best-corrected visual acuity,light-emitting diode,vision loss,low-level light therapy,mitochondria,photobiomodulation,dry age-related macular degeneration,drusen
更新于2025-09-12 10:27:22