Laser Photocoagulation
Overview
Retinal laser photocoagulation uses thermal energy from a laser beam to create controlled burns in retinal tissue. One of the oldest and most established treatment modalities in retina. Applications range from PRP for PDR to focal/grid laser for macular edema to direct treatment of vascular lesions.
Mechanism / How It Works
- Details to be added from dedicated source â wavelengths (argon green, yellow, diode), tissue absorption, thermal vs subthreshold, spot sizes, power settings
Laser for Retinal Arterial Macroaneurysm
From the RAM source:
- Technique: Moderate-intensity, large-spot (200â500 Ξm), 2â3 rows applied immediately adjacent to the macroaneurysm (not directly on it)
- Indication: Vision-threatening exudation or increasing macular edema from leaking aneurysm
- Controversy: Some studies show significant decrease in VA post-laser; risk of BRAO in up to 16% of cases
- Being increasingly supplanted by anti-VEGF in this context
Indications & Contraindications
- Indications to be expanded â PRP for PDR, focal/grid for DME, barrage laser for retinal tears, etc.
- In RAM: indicated only when visual function threatened by progressive edema
Evidence
- RAM context: conflicting evidence â some studies show benefit for exudative type, others report significant complications (Ghassemi et al., Brown et al.)
- Key trials for other indications to be added â DRS, ETDRS
Related
- retinal-arterial-macroaneurysm â direct treatment of the lesion
- fluorescein-angiography â guides treatment targeting
- bevacizumab / ranibizumab â alternative treatment modality
Sources
- macroaneurysm-eyewiki (laser in RAM context only)
Gap: Needs comprehensive sourcing on laser types, settings, PRP technique, focal/grid technique, complications, and landmark trial evidence.