Laser treatment in retinitis pigmentosa-a review
- PDF / 303,550 Bytes
- 8 Pages / 595.276 x 790.866 pts Page_size
- 1 Downloads / 184 Views
REVIEW ARTICLE
Laser treatment in retinitis pigmentosa-a review Maciej Gawęcki 1 Received: 24 January 2020 / Accepted: 4 May 2020 # Springer-Verlag London Ltd., part of Springer Nature 2020
Abstract Retinitis pigmentosa (RP) is a common inherited retinal disease for which effective treatment is not yet known. This review sought to analyze the available medical literature covering the efficacy of different forms of laser treatment for RP in laboratory and clinical trials. The PubMed database was searched using the following phrases: “laser photocoagulation”, “subthreshold laser”, “nanolaser”, “micropulse laser”, “retinitis pigmentosa”, “rod–cone dystrophy”, and “retinal dystrophy”. Results were stratified as clinical or experimental studies. Six studies involving animal models and three studies involving human subjects that examined laser treatment in RP were found. Laboratory studies on rodents favored classic laser photocoagulation as the most effective therapy for slowing the progression of proto-oncogene tyrosine-protein kinase MER–related RP. Two clinical studies on humans suggested transient but robust functional benefits of subthreshold micropulse laser treatment in RP. The available material is too scarce to define laser treatment as a standard procedure to treat RP in humans. Nondamaging retinal laser therapy should be tested more intensively in clinical trials as there is no proven negative side effect of that treatment and the theoretical background, especially the chaperone and reparative roles of heat shock proteins elicited during the procedure, supports this form of RP management. Keywords Retinitis pigmentosa . Laser photocoagulation . Subthreshold diode micropulse . Selective retina therapy
Introduction Retinitis pigmentosa (RP) is a spectrum of inherited diseases that leads to a progressive loss of photoreceptors. The prevalence of this disorder is approximately 1:4000 [1]. RP is caused by numerous gene mutations, making it difficult for scientists to develop a universal model for research on RP pathogenesis and treatment [2]. Most of the modern research has focused on elucidating genetic aspects of RP and gene therapies, which are usually very expensive to explore [3, 4]. Possible laser application in RP is not a first-line research topic nowadays, but it was examined even a few decades ago in laboratory studies on this disease (Table 1). They revealed migration of the retinal pigment epithelium (RPE) cells after laser photocoagulation (LPC), reduction of residual material in the retina, and some improvement of electroretinograms (ERG) in laboratory animals after the treatment. If applied in
* Maciej Gawęcki [email protected] 1
Dobry Wzrok Ophthalmological Clinic, Gdańsk, Poland
the clinic, the laser procedure is expected to be cheap and generally not troublesome for the patient; however, in the case of classic LPC, the treatment endpoint is a chorioretinal scar and loss of photoreceptors. Nowadays, due to technological progress, we are at the point at which laser can be applied to the reti
Data Loading...
