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Fluorescein Angiography / Indocyanine Green Digital Angiography

Fluorescein Angiography is a diagnostic procedure, which uses a special camera to take a series of photographs of the retina, the light sensitive tissue in the back of the eye. A special water-soluble dye (Fluorescein) is injected into a vein in the arm. The dye travels through the veins and into the arteries, which circulate throughout the body. As the dye passes through the blood vessels of the retina, a special camera flashes a blue light into the eye and takes multiple photographs of the retina.

If the blood vessels are abnormal, the dye may leak into the retina or stain blood vessels. Damage to the lining underneath the retina or the appearance of abnormal new blood vessels growing beneath the retina may also be revealed. The precise location of these abnormalities can be determined by a careful interpretation of the fluorescein angiogram by your physician.

Indocyanine is a green dye, which fluoresces with invisible infrared light; it requires a special digital camera that is sensitive to these light rays. The Indocyanine Green Angiogram is often better for studying the deeper choroidal blood vessel layer. Certain eye disorders are usually imaged with the fluorescein. Indocyanine is especially helpful when there is a leakage of blood, which makes interpretation of fluorescein studies difficult.

Both of these tests are considered safe and serious side effects from these tests uncommon. However, there is possibility that there may be a reaction to the dyes.

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Optical Coherence Tomography


Optical Coherence Tomography is a new technology, which can perform micron resolution imaging in biological tissues. The procedure of the OCT is similar to the ultrasound except that light is used rather than light acoustic or radio waves. Retinal thickness is a vital consideration in the assessment of many macular diseases. The OCT can be particularly useful in tracking any imperfection in the retina and optic nerve.

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Laser Treatment

In some cases, Laser Treatment can be done to prevent or lessen severe loss of eyesight, if the CNV (abnormal blood vessels) is discovered early enough. The laser beam is a high-energy light that turns to heat when it hits the parts of the retina to be treated. This heat destroys the CNV and stops it from growing, leaking, and bleeding. A scar forms because of the treatment and this scar creates a permanent blind spot in the field vision.

Vision does not usually improve after Laser Treatment and in some cases, may even be somewhat worse. However, loss of vision following the Laser Treatment, though immediate, is usually less severe that the eventual loss of vision that usually occurs if the Laser Treatment is not done. In many cases, the visual distortion will disappear after laser treatment.

Laser Treatment only works about half the time. Since macular degeneration is a condition that is caused by the aging process, Laser Treatment is often only a means of temporarily preventing further loss of vision, or lessening the amount of visual loss that usually occurs.

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Photodynamic Therapy

This type of laser surgery may be done in one or more sessions. The idea is to use the laser to destroy all of the damaged areas of retina where the blood vessels have been obstructed. When these areas are treated with the laser, the retina is likely to stop manufacturing new blood vessels, and those that are already present tend to become inactive or disappear.

There are side effects of pan retinal laser photocoagulation. When only a small amount of neovascularization is present, your doctor may suggest careful follow-up examinations. Nevertheless, the longer the eye remains untreated the more likely vision will be lost and blindness will occur. The earlier severe neovascularization is discovered and the eye is treated with laser, the more likely blindness can be prevented. If you have developed neovascularization, your doctor will advise you about when pan retinal laser photocoagulation should be done.

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Transpupillary Thermotherapy

One of the most recent treatments for Chorodial Neovasular Membranes for patients with age related macular degeneration is Transpupillary Thermotherapy. With TTT treatment 19 per cent of the patients will show two or more lines of improvement in the vision, 50 per cent will have stable vision or improvements by one line and 25 per cent will show decreased vision. Some patients may require more than one treatment. Thermal energy from a special laser disrupts the abnormal Chorodial Neovasular Membranes, keeping the overlying retinal tissue intact.

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