OCT 25, 2013
History of Retinal Photocoagulation and PDT
By Daniel Palanker, PhD; Reginald Birngruber, PhD
Laser Surgery Education Center
Comprehensive Ophthalmology, Retina/Vitreous
In this interview, Dr. Reginald Birngruber describes the evolution of retinal photocoagulation, starting with Meyer-Schwickerath's discovery of the therapeutic effects of intense sun light on the retina, and subsequent developments of retinal photocoagulation with xenon arc, krypton, and argon lasers. Dr. Birngruber also describes the development of photodynamic therapy (PDT) with the use of a photosensitizer specifically bound to new vasculature. Activated by the laser light, the photosensitizer produces reactive oxygen species and thereby destroys new blood vessels. Photodynamic therapy became the first therapy for the wet form of age-related macular degeneration (AMD). While anti-VEGF therapy is now the mainstay treatment for wet AMD, it is less effective in cases of polypoidal vasculopathy, seen more frequently in Asian populations. As a result, many Japanese clinicians use a combination of PDT and pharmacologic therapy to treat their patients.