Uloga lasera u liječenju makularnih bolesti

master's thesis

• Title (english): The role of laser in the treatment of macular diseases
• Author: Ilija Koštro
• Mentor: Tomislav Jukić (mentor)
• Committee member: Damir Katušić (predsjednik povjerenstva)
• Committee member: Miro Kalauz (član povjerenstva)
• Committee member: Tomislav Jukić (član povjerenstva)
• Granter: University of Zagreb; School of Medicine; (Department of Ophthalmology and Optometry); Zagreb
• Defense date and country: 2015-07-15, Croatia
• Scientific / art field, discipline and subdiscipline: BIOMEDICINE AND HEALTHCARE; Clinical Medical Sciences; Ophthalmology

Abstract

Različite bolesti mogu oštetiti makularnu funkciju. Dijabetička retinopatija je među najčešćim očnim bolestima i vodeći uzrok sljepoće u odraslog stanovništva. Uzrokovana je promjenama retinalnih krvnih žila. Kod nekih pacijenata krvne žile oteknu pa oko njih nastaje edem, dok kod drugih dolazi do rasta novih, abnormalnih krvnih žila. Okluzija mrežničnih vena označava opstrukciju malih vena retine koje odvode vensku krv iz retine. Retina je sloj fotoosjetljivog tkiva koji sliku sa očne pozadine prevodi u živčane signale koji idu dalje na obradu u mozak. U liječenju proliferativne retinopatije i okluzije retinalnih vena koristi se laserska fotokoagulacija. Laserska fotokoagulacija koristi toplinu laserske zrake da bi koagulirala abnormalnu, nefunkcionalnu krvnu žilu na retini. Dva su osnovna pristupa u liječenju dijabetičke retinopatije laserom: izravna (fokalna) fotokoagulacija i tzv. ''grid'' (rešetka) tehnika. Fokalna tehnika se koristi s ciljem da se koagulira specifična krvna žila na malom području retine, obično u blizini makule. Oftalmolog mora identificirati točno određenu krvnu žilu koju će tretirati točno određenim brojem laserskih pečata. Cilj ''grid'' tehnike je također sužavanje abnormalnih krvnih žila. U ovom slučaju oftalmolog će primijeniti 1000 do 2000 laserskih pečata na retini, pri tomu čuvajući područje makule. Za takvo liječenje koristi se velik broj laserskih pečata pa je nužno potpuni tretman provesti u nekoliko navrata. Ova tehnika može oštetiti neke aspekte vida, naročito percepciju boja i noćni vid, ali je ipak relativno dobar ostatak vidne funkcije.

Abstract (english)

A range of problems can affect macula. Diabetic retinopathy is the most common diabetic eye disease and a leading cause of blindness in adults. It is caused by changes in the blood vessels of the retina. In some people with diabetic retinopathy, blood vessels may swell and leak fluid. In other people, abnormal new blood vessels grow on the surface of the retina. Retinal vein occlusion is a blockage of the small veins that carry blood away from the retina. The retina is the layer of tissue at the back of the inner eye that converts light images to nerve signals and sends them to the brain. Proliferative retinopathy and retinal vein occlusion are treated with laser photocoagulation. Laser photocoagulation uses the heat from a laser to seal or destroy abnormal, leaking blood vessels in the retina. One of two approaches may be used when treating diabetic retinopathy: focal photocoagulation or grid photocoagulation. Focal treatment is used to seal specific leaking blood vessels in a small area of the retina, usually near the macula. The ophthalmologist identifies individual blood vessels for treatment and makes a limited number of laser burns to seal them off. Grid laser treatment helps to shrink the abnormal blood vessels. 1,000 to 2,000 laser burns are placed in the areas of the retina away from the macula, causing the abnormal blood vessels to shrink. Because a high number of laser burns is necessary, two or more sessions usually are required to complete treatment. Although you may notice some loss of your side vision, grid laser treatment can save the rest of your sight. Scatter laser treatment may slightly reduce your color vision and night vision.

• Keywords: dijabetes; mrežnica; makula; dijabetička retinopatija; okluzija mrežničnih vena; makularni edem; laserska fotokoagulacija; izravna fotokoagulacija; grid tehnika
• Keywords (english): diabetes; retina; macula; diabetic retinopathy; retinal vein occlusion; macular edema; laser photocoagulation; focal photocoagulation; scatter photocoagulation
• Language: croatian
• URN:NBN: urn:nbn:hr:105:931473
• Study programme: Title: Medicine; Study programme type: university; Study level: integrated undergraduate and graduate; Academic / professional title: doktor/doktorica medicine (doktor/doktorica medicine)
• Type of resource: Text
• File origin: Born digital
• Access conditions: Open access
• Created on: 2016-08-16 09:43:00