Research towards development of a dynamic reflectometer for control of laser-induced retinal photocoagulation

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Abstract
Laser-induced photocoagulation is used routinely to treat a variety of retinal disorders. In this procedure, absorption by the retina and choroid of focused laser light creates thermal lesions that provide the therapeutic effect. The treatment endpoint is determined by the ophthalmoscopical visibility of the coagulation resulting from the increased diffuse reflectivity of the fundus at the lesion site. To date, it is impossible, prior to treatment, to predict the effectiveness of a specific dosage of laser radiation -- the result can be assessed only after the exposure, and only subjectively. To avoid side effects like hemorrhage, macular pucker, and post-coagulative retinal detachments that can result from excessive local heating, a device for automatically controlling the laser exposure parameters is needed. Preliminary research aimed toward development of such a device has now been completed. The technique employs a simple electro-optical detector to monitor the changing reflectivity of the lesion during the laser exposure, and couples that information to a microcontroller which automatically adjusts the laser exposure parameters. The first results of a clinically realistic device are reported.

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