Role of the Scanning Laser Ophthalmoscope in Photodynamic Therapy of Macular Disease

摘要

Photodynamic therapy (PDT) is a new treatment modality for exudative forms of age-related maculopathy. It can be combined with others types of selectivbe or conventional laser therapy. Imaging and functional testing with the scanning laser ophthalmoscope (SLO) are importnat for detailed diagnostic information as well as for the interpretation of the long term outcome of different treatment strategies. For example, infrared imaging in a confocal mode superbly outlines areas of minimal edema due to slow leakage and switching of wavelengths enables simultaneous and repeated angiographic studies of the retina with the same instrument. Visual acuities are strongly indfluenced by background illuminance and binocular fixation patterns, and absolute but not incremental microperimetric thresholds measure correctly the functional status of the photoreceptor-pigment epithelium complex. The scanning laser ophthalmoscope has bene adapted for use as a delivery system in microphotocoagulation and photodynamic therapy. A non-scanning external therapeutic laser source uses the same Maxwellian view entrance location into the eye as the SLO. Advantages include a non-contact delivery. Fixation control, registration of treatment locations, and the possibility tospatially modulate the area being treated.