What is the role of feeder vessel photocoagulation in the treatment of hemoglobinopathy retinopathy?

Updated: Sep 03, 2019
  • Author: Brian A Phillpotts, MD; Chief Editor: Hampton Roy, Sr, MD  more...
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Answer

Obliterating feeder vessels by retinal photocoagulation has been used to cause infarction of peripheral neovascular beds.

This technique has been shown to manage proliferative sickle retinopathy effectively, especially in cases where neovascularization has persisted after extensive scatter photocoagulation treatment.

Feeder vessel photocoagulation frequently is complicated by the following: vitreous hemorrhage, retinal detachments, choroidal ischemia, choroidal neovascularization, subretinal hemorrhage and/or fibrosis, or macular pucker and hole formation.

To reduce complications, the feeder vessel technique has been modified into 2 sessions, permitting reduction in laser power. On initial treatment, laser burns are low intensity; upon follow-up, a second set of low-intensity burns are superimposed on the initial ones.

The method has been proposed to decrease the incidence of the Bruch membrane penetration, thereby decreasing the chance for choroidal neovascularization.

Scatter photocoagulation is the preferred technique.

Feeder vessel photocoagulation seldom is used because of its high complication rate. When used, feeder vessel photocoagulation is usually an adjunct to scatter photocoagulation.

Regular follow-up care is needed to detect and treat complications and new neovascularization.


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