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Updated: May 9, 2026

Continuous-wave Thulium Laser for Heating Cultured Cells to Investigate Cellular Thermal Effects
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Subvisible retinal laser therapy: titration algorithm and tissue response.

Daniel Lavinsky1, Christopher Sramek, Jenny Wang

  • 1*Department of Ophthalmology, Stanford University, Stanford, California; †Universidade Federal do Rio Grande do Sul, Hospital de Clinicas de Porto Alegre, Department of Ophthalmology, Porto Alegre, RS, Brazil; and ‡Topcon Medical Laser Systems, Inc., Santa Clara, California.

Retina (Philadelphia, Pa.)
|July 23, 2013
PubMed
Summary
This summary is machine-generated.

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A new laser dosimetry algorithm, Endpoint Management, precisely controls retinal tissue damage for therapeutic applications. This method enables predictable outcomes from nondestructive to coagulative effects, paving the way for advanced retinal treatments.

Area of Science:

  • Ophthalmology
  • Biomedical Engineering
  • Retinal Research

Background:

  • Laser therapy is used for retinal diseases, but lacks precise dosimetry for predictable tissue damage.
  • Current laser settings range widely, from intense burns to nondamaging exposures, without a clear calibration method.

Purpose of the Study:

  • To verify and calibrate a computational model-based titration algorithm for predictable laser dosimetry.
  • To achieve predictable retinal tissue damage, ranging from nondamaging to intense coagulative effects.

Main Methods:

  • Utilized the Endpoint Management algorithm, based on a computational model of retinal photothermal damage, to set laser parameters.
  • Experimentally verified the algorithm in Dutch Belted rabbits using a PASCAL Streamline 577 laser, titrating energy levels from 30% to 170% of a nominal dose.

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  • Employed multimodal in vivo imaging (fundus autofluorescence, fluorescein angiography, SD-OCT) and ex vivo microscopy (light, SEM, TEM) to assess tissue effects.

    • Main Results:

    • Energy levels of 170% and 120% produced moderate and light burns, respectively, affecting retinal pigment epithelium, photoreceptors, and inner retina.
    • Subvisible lesions (50%-75%) showed selective damage to retinal pigment epithelium and photoreceptors, detectable by angiography and OCT.
    • Nondamaging lesions (<30%) were invisible in vivo, with minimal retinal pigment epithelium damage; photoreceptor and synapse restoration observed in lesions ≤100%.

    Conclusions:

    • The Endpoint Management algorithm provides a reproducible retinal laser dosimetry protocol for predictable morphological changes in animal models.
    • This validated algorithm facilitates clinical trials for subvisible and nondestructive retinal therapies, particularly for macular disorders.