PubMed · 653030
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I I Giăvan. [Modified cyclodiastasis].. https://pubmed.ncbi.nlm.nih.gov/653030/
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Transscleral cyclophotocoagulation was performed in human autopsy eyes by using three Nd:YAG lasers with different durations of exposure: a pulsed, contact laser with a duration of 0.75 millisecond and a range of one to ten pulses per burst (GLase 106, Sunrise Technologies, Fremont, California); a pulsed, noncontact laser with a duration of 20 milliseconds (Microruptor 2, Lasag Medical Lasers, Thun, Switzerland); and a continuous-wave, contact laser with durations of 700 and 2,000 milliseconds (Microruptor 3, Lasag Medical Lasers, Thun, Switzerland). Tissue responses were observed with a high-magnification videographic recording technique to analyze the immediate, real-time laser effects, and by light microscopy to characterize the laser-induced lesions further. Videographically, both pulsed lasers were noted to cause mild whitening of the pigment epithelium with frequent vaporization and explosive tissue disintegration. Histologically, the 0.75-millisecond pulse typically produced the most marked epithelial disruption, referred to as an explosive-like lesion, whereas the 20-millisecond pulse more often caused moderate tissue disruption with elevation of the epithelial layers in a blister-like lesion. In contrast, the continuous-wave laser was observed videographically to produce prominent tissue whitening and puckering, seen histologically as convolution of the epithelium and coagulation of stroma, which was called a shrinkage-like lesion. Our study suggests that exposure duration influences in vitro tissue response to transscleral Nd:YAG cyclophotocoagulation, although in vivo studies and clinical trials are needed to determine which tissue response is optimum for clinical use.
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Cilioretinal arteries were noted to accompany pits of the optic disc in 16 of 25 cases (64%). Fourteen of the 16 cases were found to have 2 cilioretinal arteries (86%). The cilioretinal arteries were directly related to the pit of the disc and emerged either from the bottom or the margin of the pit in a proportion of 86%. This finding reinforces the assumption that the optic disc pit belongs to the same spectrum of congenital anomalies which also includes optic disc coloboma, megalopapilla and morning glory syndrome. A fluorescein angiography study showed hyperfluorescence of the pit in 12/16 cases and in particular in all the cases in which both cilioretinal arteries emerged from the pit. Hypofluorescence was noted in 7/9 cases in which the pit was not associated with cilioretinal arteries. Our findings could support the view that hyperfluorescence of the pit, which is not a constant phenomenon, mostly depends on the presence of cilioretinal arteries emerging from the pit.