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|Posted By : Dr.Hanspal, MBBS, MS ,FAGE|
|Posted On : 11 Jul 2009 (Total Views : 4780)|
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A NEW TECHNIQUE FOR C.R.V.O (CENTRAL or BRANCH RETINAL VEIN OCCLUSION) BY LASER BLAST THERAPY The small blood vessels that drain blood from the retina (retinal veins) can sometimes become blocked as part of the aging process. This is more common in patients with diabetes or high blood pressure. A retinal vein occlusion can cause the retina to swell with fluid and blood, blurring central and peripheral vision. Other times, new blood vessels may grow and cause pain with very high pressure inside the eye (neovascular glaucoma). Laser treatment can help reduce this swelling or cause the new blood vessels to disappear plus with latest technique “LASER BLAST THERAPY” perfected by Dr.Gurbax Singh ( director) & Dr. Hanspal S. Bhinder at G.G.S.I. Eye Research & Cure Centre (31,defence enclave, vikas marg,Opp Preet vihar petrol pump & subway delhi-92 one can get rid of disease (retinal vein occlusions).
What is Central Retinal Vein Block?
Blood is supplied by central retinal artery to the inner part of retina. Impure blood is drained out of the eye by central retinal vein. The arteries and veins cross each other at many points. The blockage of CRV can occur at many places.
What are the causes of CRVO?
Change in blood chemistry liquid (high cholesterol, abnormal proteins); Change in the viscosity of the blood;Change in the cellular content of the blood (Red Blood Cells & White Blood Cells) ;Change in the wall of the vein & Compression from outside on the vein. (Old age changes in the veins and arteries due to high blood pressure and diabetes mellitus contribute a major role)
What are the sites of CRVO?
Block can occur: - Behind the optic disc ;On the disc ;1st AV or 2nd Arterio Venous crossing.
What are symptoms?
Patient gets up and finds he cannot see from one eye or is very hazy. Before this episode, he may complain of transient attacks of dim vision lasting for few seconds to minutes and automatic restoration.
How does the doctor diagnose?
He finds a classical picture of retinal hemorrhages. In the retina as if an artist, has sprinkled red color on retina with his brush and the veins are dilated. At our Centre( G.G.S.I.Eye Research & cure centre) we take digital photograph of retina.
How such cases were treated?
World wide there were no proper treatment for this condition,
(1) Wait and watch for glaucoma and abnormal vessels
(2) Pharmacological opening of vein lumen Anti-fibrinolytic (Streptokinase and others) or Anti coagulants
(3) Isometric Haemodilution by giving dextran infusion
(4) 30% photocoagulation by argon laser (Branch vein occlusion) :-
i. It burns the retina which releases vasoproliferative factor (vascular poison)
ii. Photocoagulation burns budding vessels. There is only 30% improved with earlier treatment.
i. Decompression of the optic nerve sheath
ii. Sheathotomy by vitrectomy iii. Creation of chorio retinal anastomosis.
Note: - Complication are serious: - Retinal Detachment, Cataract and Central Retinal artery occlusion. The above treatment has been mostly of:
(1) Wait and watch for the complications to arises and then deal. The period lasts for 3 months to 2 years.
(2) Photocoagulation: - It is to treat the complication. Results in U.S.A. study groups are not very remarkable as regard improvement in visual acuity.
(3) Surgical is hazardous as reported by some scientific workers.
What are you doing in these cases?
OUR EYE CENTRE( G.G.S.I.Eye Research & cure centre) Protocol :
(1) To investigate and find out the cause and treat it accordingly.
(2) Blast Therapy to the veins or its branches and opening of the block vein with the help of special technique of laser. It is the only centre in world which opens blocked vein by special laser technique .
How do you know this technique has helped?
1. In other techniques people are not sure about their results because with passage of time some cases may improve to 1 or 2 lines (20%).
2. But In our technique , the result is dramatic as on next, the patients who couldn’t see earlier starts reading about 3-4 line at distance.
3. The improvement is rapid and takes about 6 weeks for complete cure. While in other techniques improvements starts from 3 months and goes up to 3 years or more. percentage of cure is very less.
The Most Important Message: - There are many patients of old ages suffering from hypertension, diabetes or otherwise who can get blocked central retinal vein. In normal course of events and the therapy available is a drawn out process with indefinite horrible outcome. The people can lose their eyesight either due to 100-day glaucoma or from membrane formation in the retina leading to drastic complications. we want to tell my countrymen and my fellow colleagues in all the specialty disciplines that this new modality of treatment is very beneficial for the patients.
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