title: Selective targeting of the retinal pigment epithelium using an acousto-optic laser scanner.
abstract: Selective targeting of the retinal pigment epithelium (RPE) is a new strategy for treating certain retinal disorders while preserving adjacent photoreceptors. The treatment currently relies on a complex laser system to produce the required microsecond pulse structure. In our new approach, we scan the focus of a continuous-wave (cw) laser beam with acousto-optic deflectors to produce microsecond-long exposures at each RPE cell. Experiments were performed in vitro with a bench-top scanner on samples of young bovine RPE and in vivo on Dutch belted rabbits with a slit-lamp adapted scanner. Effective dose 50% (ED50) for RPE damage was determined in vitro by fluorescence cell viability assay and in vivo by fluorescein angiography. Damage to individual RPE cells was achieved with laser power on the order of 100 mW. Using separated scan lines, we demonstrate selectivity in the form of alternating lines of dead and surviving cells that resemble the scan pattern. Selectivity is also shown by the absence of retinal thermal coagulation in vivo. Selective RPE damage is feasible by rapidly scanning a cw laser beam. The scanning device is an attractive alternative to conventional laser coagulation and pulsed laser targeting of the RPE.
authors.affiliation: Massachusetts General Hospital, Harvard Medical School, Wellman Center for Photomedicine, Boston, Massachusetts 02114, USA. alt@helix.mgh.harvard.edu
authors.forename: Clemens
authors.initials: C
authors.lastname: Alt
authors.forename: Carsten
authors.initials: C
authors.lastname: Framme
authors.forename: Susanne
authors.initials: S
authors.lastname: Schnell
authors.forename: Ho
authors.initials: H
authors.lastname: Lee
authors.forename: Ralf
authors.initials: R
authors.lastname: Brinkmann
authors.forename: Charles P
authors.initials: CP
authors.lastname: Lin
mesh_terms: D000162:Acoustics / Q000295:instrumentation*; D000818:Animals; D002417:Cattle; D002470:Cell Survival / Q000528:radiation effects; D002478:Cells, Cultured; D004847:Epithelial Cells / Q000473:pathology* / Q000528:radiation effects*; D004867:Equipment Design; D019544:Equipment Failure Analysis; D066298:In Vitro Techniques; D017075:Laser Coagulation / Q000295:instrumentation* / Q000379:methods; D010857:Pigment Epithelium of Eye / Q000473:pathology* / Q000528:radiation effects / Q000601:surgery*; D011817:Rabbits; D012680:Sensitivity and Specificity; D016896:Treatment Outcome