Industrial projects (references)
Selective retinal therapy (SRT) was developed at the Medical Laser Center Lübeck, tested in the laboratory, preclinically and clinically. The MLL has worked together with various national and international industrial partners and clinics on various aspects of the SRT.
Recent work has focused on automatic dose-controlled laser therapy, which frees the doctor from any manual dose of radiation. A corresponding laser system of a cooperation partner is currently undergoing clinical trials.
SRT is a new, gentle laser treatment method for various diseases of the fundus, i.a. Retinopathy Centralis serosa (RCS) and diabetic macular edema associated with reduced function of retinal pigment epithelium (RPE).
The RPE is a monocellular hexagonal cell layer (Fig. 1) on the Bruch’s membrane that separates the photoreceptors from the supplying choroid. The RPE regulates the metabolism of the retina.
With SRT, the RPE in the irradiated area is selectively treated by microsecond laser pulses. Microvaporization on the melanin granules of the cell (Figure 2A) results in photodisruption of the irradiated cells, whereby the adjacent neurosensory retina with the photoreceptors and the choroid underlying the RPE are not damaged (Figure 1: dark cells selectively damaged, green vital; Fig. 2 A yellow marked cells). Therapy ideally leads to regeneration of the RPE and Bruch’s membrane (Figure 2B) and increased metabolism at the chorioretinal junction.
In contrast to established laser photocoagulation (Figure 3A), in which the irradiated and surrounding areas of the retina are obliterated, scotomas are completely absent in SRT (Figure 3B). As a result, however, the laser effects are not visible to the attending physician during the therapy, and only later fluorescence angiography can be used to show selective damage at the irradiated areas (Fig. 3C).
Current research topics include:
- Optimization of the irradiation
- Real-time visualization and dynamics of microvaporisation
- Automatic therapy control and dosage
- Clinical studies on various diseases