{"id":3279,"date":"2022-11-02T12:38:11","date_gmt":"2022-11-02T12:38:11","guid":{"rendered":"https:\/\/profmunteanu.ro\/?p=3279"},"modified":"2023-09-05T09:38:32","modified_gmt":"2023-09-05T08:38:32","slug":"fotocoagularea-laser-ce-este-si-la-ce-se-utilizeaza","status":"publish","type":"post","link":"https:\/\/profmunteanu.ro\/de\/fotocoagularea-laser-ce-este-si-la-ce-se-utilizeaza\/","title":{"rendered":"Fotocoagularea laser \u2013 Ce este si la ce se utilizeaza"},"content":{"rendered":"
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Fotocoagularea laser \u2013 Ce este, utilizari,
beneficii, recuperare<\/h1>\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t
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Fotocoagularea laser reprezint\u0103 un procedeu medical inovator, utilizat \u00een tratamentul anumitor afec\u021biuni oftalmologice. Prin aceast\u0103 tehnic\u0103, se utilizeaz\u0103 o surs\u0103 de lumin\u0103 laser de \u00eenalt\u0103 intensitate pentru a coagula \u021besuturile deteriorate sau anormale din ochi. Fotocoagularea laser are multiple indica\u021bii terapeutice, fiind utilizat\u0103 \u00een tratamentul retinopatiei diabetice, degenerescen\u021bei maculare legate de v\u00e2rst\u0103 \u0219i glaucomului. Aceast\u0103 procedur\u0103 minim invaziv\u0103 ofer\u0103 beneficii semnificative pacien\u021bilor, reduc\u00e2nd simptomele \u0219i \u00eencetinind evolu\u021bia afec\u021biunilor oculare.<\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t

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1. Fotocoagularea laser - tratament pentru diverse boli oculare<\/h2>\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t
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De zeci de ani, terapia cu laser<\/a> este folosit\u0103 pentru a trata multe patologii la nivelul ochiului. Un laser cu arc cu xenon a fost dezvoltat \u00een anii 1950 de c\u0103tre Laboratorul Carl Zeiss \u0219i a fost utilizat clinic \u00een primele zile ale terapiei retiniene. Laserul cu argon a fost descoperit \u00een 1964 de William Bridges. Cu toate acestea, un studiu oficial pentru a investiga efectele tratamentului cu laser prin fotocoagulare nu a fost efectuat p\u00e2n\u0103 \u00een anii 1970. Studiul Retinopatiei Diabetice (SRD) a examinat efectele fotocoagul\u0103rii pan-retiniene (FPR) at\u00e2t prin tratamente laser cu xenon, c\u00e2t \u0219i cu laser cu argon asupra pacien\u021bilor cu retinopatie diabetic\u0103 proliferativ\u0103 (RDP), pentru a determina dac\u0103 evolutia bolii a fost influentata de tratamentul laser dec\u00e2t f\u0103r\u0103 tratament deloc. Studiul a ar\u0103tat c\u0103 terapia cu laser a fost \u00eentr-adev\u0103r benefic\u0103 pentru pacien\u021bii cu RDP \u0219i, de asemenea, a ar\u0103tat c\u0103 laserele cu argon au creat mai pu\u021bine efecte adverse pentru pacien\u021bi, dec\u00e2t laserele cu xenon, p\u0103str\u00e2nd \u00een acela\u0219i timp o eficacitate similar\u0103. Acest studiu a stabilit, de asemenea, primii parametri de tratament detalia\u021bi pentru RDP. Ca urmare, terapia cu laser cu xenon nu mai este folosita la scara larga, \u00een favoarea laserului cu argon (sau a sistemelor moderne echivalente cu laser \u00een milisecunde cu und\u0103 continu\u0103). Studiul Early Treatment Diabetic Retinopathy Study (ETDRS), realizat la scurt timp dup\u0103 SRD, a examinat efectele FPR asupra pacien\u021bilor cu retinopatie diabetic\u0103<\/a> neproliferativ\u0103 (RDNP) \u0219i a determinat stadiul exact al evolu\u021biei bolii \u00een care ar trebui administrat\u0103 terapia cu laser. \u00cen prezent, apar sisteme de livrare cu laser mai avansate \u0219i alte metode de combatere a retinopatiei diabetice. Cu toate acestea, fotocoagularea laser r\u0103m\u00e2ne principalul tratament pentru retinopatia diabetica proliferativa.<\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t

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Face\u021bi primul pas spre o vedere mai buna cu ajutorul medicilor specializa\u021bi \u00een oftalmologie de la
Prof. Dr. Munteanu Ophthalmologisches Zentrum<\/h2>\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t
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2. Cum actioneaza laserul asupra retinei<\/h2>\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t
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Lumina de la laser este absorbit\u0103 de epiteliul pigmentar retinian (EPR) \u0219i de coroida subiacent\u0103. Pigmen\u021bii retinieni din EPR servesc pentru a absorbi aproape toate lungimile de und\u0103 ale luminii. Pentru FPR, se utilizeaz\u0103 de obicei lumin\u0103 laser galben\u0103, verde sau ro\u0219ie. Energia laserului este absorbit\u0103 si este convertit\u0103 \u00een energie termic\u0103, ridic\u00e2nd temperatura \u021besutului cu aproximativ 20 sau 30 de grade Celsius. Arsurile termice denatureaz\u0103 proteinele tisulare, ceea ce duce la moartea local\u0103 a celulelor retiniene \u0219i la necroz\u0103 coagulativ\u0103. \u00cen timp, aceste zone de \u021besut deteriorat termic cicatriciaz\u0103 \u0219i devin mai puternic pigmentate, l\u0103s\u00e2nd cicatrici laser vizibile la nivelul EPR. \u00cen mod clasic, pe retin\u0103 se fac aproximativ 1000-2000 de micro-arsuri. Prin distrugerea retinei extramaculare ischemice, \u00een mare parte neutilizata, fotocoagularea laser reduce aria \u021besutului ischemic, care, la r\u00e2ndul s\u0103u, reduce produc\u021bia total\u0103 de factor de cre\u0219tere a endoteliului vascular (VEGF) \u00een ochi \u0219i reduc\u00e2nd astfel stimulul pentru aparitia neovascularizatiei.<\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t

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3. Cum se realizeaza o sedinta de fotocoagulare laser retiniana?<\/h2>\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t
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Laserul este livrat de obicei fie printr-un biomicroscope sau uneori fie printr-un oftalmoscop indirect cu laser.<\/p>

Biomicroscopul: Laserul este ata\u0219at la biomicroscop, iar energia laserului este furnizat\u0103 \u00een mod coaxial. Pacientul este a\u0219ezat, iar b\u0103rbia este a\u0219ezat\u0103 pe mentoniera aparatului. O lentil\u0103 de contact, care concentreaz\u0103 laserul pe retin\u0103, este plasat\u0103 pe cornee cu un agent de cuplare transparent. \u00cen mod obi\u0219nuit, se folose\u0219te o lentil\u0103 cu unghi larg sau oglind\u0103. Laserul trece prin cornee, camera anterioar\u0103 \u0219i cristalin \u0219i se concentreaz\u0103 pe retin\u0103 prin lentila de contact. Procedura se realizeaza cu anestezie locala cu picaturi si nu este dureroasa. Necesita dilatarea pupilei, iar cateva ore dupa tratamentul laser pacientul vede neclar.<\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t

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4. Indicatii<\/h2>\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t
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Fotocoagularea laser retiniana este indicat pentru tratarea ischemiei \u0219i a neovascularizatiei retiniene, indiferent de cauz\u0103. Cu toate acestea, tratamentul laser este cel mai frecvent utilizat pentru retinopatia diabetic\u0103 proliferativ\u0103.<\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t

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5. Efecte adverse<\/h2>\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t
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Pacien\u021bii vor experimenta niveluri diferite de disconfort \u00een func\u021bie de tipul \u0219i durata tratamentului laser primit. \u00cen timpul procedurii, pacien\u021bii vor experimenta adesea o mic\u0103 senza\u021bie de \u201eciupire\u201d cu fiecare arsur\u0103 creat\u0103 \u00een ochiul afectat. Din acest motiv, tratamentul de fotocoagulare laser poate fi \u00eemp\u0103r\u021bit \u00een mai multe sesiuni. Dac\u0103 pacientul nu poate tolera tratamentul laser administrat cu ajutorul unuei lentile de contact, laserul poate fi efectuat folosind un oftalmoscop indirect. Cu toate acestea, pentru livrarea indirect\u0103 de fotocoagulare laser, anestezia retrobulbar\u0103 este de obicei utilizata \u0219i pacien\u021bii nu pot vedea p\u00e2n\u0103 la trei – patru ore dupa procedura, atunci cand efectul \u00a0anesteziei dispare.<\/p>

Dup\u0103 procedur\u0103, este normal ca pacien\u021bii s\u0103 aib\u0103 dureri de cap u\u0219oare; se poate administra \u00a0un analgezic oral potrivit pentru gestionarea durerii. Pacien\u021bii pot prezenta adesea unele sc\u0103deri permanente ale vederii periferice, ale culorii \u0219i ale vederii nocturne. Pacien\u021bii care \u00eent\u00e2mpin\u0103 simptome neobi\u0219nuite dup\u0103 tratamentul laser, cum ar fi aparitia fulgerelor, flocoanelor flotante, durere, ro\u0219ea\u021b\u0103, o sc\u0103dere semnificativ\u0103 a vederii sau senza\u021bia c\u0103 c\u00e2mpul lor vizual<\/a> este obstructionat de o perdeaua neagr\u0103, ar trebui s\u0103-\u0219i sune imediat oftalmologul. Exudatul coroidian este un efect secundar destul de neobi\u0219nuit, care poate provoca o agravare temporar\u0103 a vederii. De obicei, nu sunt indicate medicamente dup\u0103 tratamentul cu laser. Unii medici pot alege s\u0103 suplimenteze tratamentul laser cu injec\u021bii intravitreene cu anti-VEGF. Pacien\u021bii pot relua toate activit\u0103\u021bile normale imediat dup\u0103 ce au primit terapia cu laser retinian.<\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t

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La Centrul Oftalmologic Prof. Dr. Munteanu dispunem de experien\u021ba \u0219i aparatura de varf la nivel mondial pentru tratamentul diferitelor afec\u021biuni oftalmologice.<\/h2>\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t
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6. Panfotocoagularea laser \u0219i terapia farmacologic\u0103 a retinopatiei diabetice<\/h2>\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t
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Medicamentele anti-factor de cre\u0219tere endotelial vascular (VEGF) sunt o alternativ\u0103 de tratament dar \u0219i o terapie complementara laserului. Tratamentele anti-VEGF sunt utilizate in cazurile cu acuitate vizuala \u00a0mult scazuta, in care exista edem macular pierderea \u00a0central a vederii. Acestea sunt astfel considerate un tratament mai bun dec\u00e2t tratamentul laser pentru pacien\u021bii cu edem macular diabetic extins, mai ales ca laser nu poate fi aplicat in zonele centrale retiniene. \u00cen prezent, sunt utiliza\u021bi trei agen\u021bi anti-VEGF pentru retinopatia diabetica cu edem macular: bevazicumab, ranibizumab \u0219i aflibercept. Se crede c\u0103 to\u021bi ace\u0219ti agen\u021bi sunt aproximativ egali ca eficacitate \u00een retinopatia diabetica. Desi exista mai multe cercetari pentru tratamentul retinopatie diabetice, cu diverse optiuni de tratament, unele bazandu-se doar pe injectii intravitreene cu anti-VEGF altele utilizand doar tratamentul laser, concluzia este ca fiecare pacient trebuie sa dispuna de un tratament adecvat adaptat situatie retiniene si evaluand raportul risc\/beneficiu.. Rezultate vizuale slabe pot ap\u0103rea la pacien\u021bii care nu reu\u0219esc s\u0103 fie monitorizati lunar si nu beneficiaza de tratamente oculare specializate.<\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t

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Descoperi\u021bi mai multe informa\u021bii valoroase despre oftalmologie \u0219i s\u0103n\u0103tatea ochilor vizion\u00e2nd materialele realizate de exper\u021bi \u00een domeniu de pe canalul nostru de YouTube<\/span><\/a>.<\/em><\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t

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\"Oftalmologie<\/figure>

Arbeitsdirektorin Dr. Alexandra Preda, PhD<\/h3>

Dr. Alexandra Preda, prim\u00e4re Augen\u00e4rztin, Leiterin der Abteilung f\u00fcr Augenheilkunde - Universit\u00e4t f\u00fcr Medizin und Pharmazie \"Victor Babes\" Timisoara, Doktorin der medizinischen Wissenschaften, mit Spezialisierung unter der Koordination von Prof. Dr. Munteanu Mihnea, Erlangung europ\u00e4ischer Akkreditierungen nach Spezialisierungskursen in diesem Bereich in \u00d6sterreich, Bulgarien, Slowenien, T\u00fcrkei.<\/p><\/div><\/div>\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t

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Fotocoagularea laser \u2013 Ce este, utilizari, beneficii, recuperare Fotocoagularea laser reprezint\u0103 un procedeu medical inovator, utilizat \u00een tratamentul anumitor afec\u021biuni oftalmologice. Prin aceast\u0103 tehnic\u0103, se utilizeaz\u0103 o surs\u0103 de lumin\u0103 laser de \u00eenalt\u0103 intensitate pentru a coagula \u021besuturile deteriorate sau anormale din ochi. Fotocoagularea laser are multiple indica\u021bii terapeutice, fiind utilizat\u0103 \u00een tratamentul retinopatiei diabetice, […]<\/p>\n","protected":false},"author":1,"featured_media":3950,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"om_disable_all_campaigns":false,"footnotes":""},"categories":[5],"tags":[],"class_list":["post-3279","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-articole"],"yoast_head":"\nFotocoagularea laser \u2013 Ce este si la ce se utilizeaza - Clinica Oftalmologica Dr. Munteanu<\/title>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/profmunteanu.ro\/de\/fotocoagularea-laser-ce-este-si-la-ce-se-utilizeaza\/\" \/>\n<meta property=\"og:locale\" content=\"de_DE\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"Fotocoagularea laser \u2013 Ce este si la ce se utilizeaza - Clinica Oftalmologica Dr. Munteanu\" \/>\n<meta property=\"og:description\" content=\"Fotocoagularea laser \u2013 Ce este, utilizari, beneficii, recuperare Fotocoagularea laser reprezint\u0103 un procedeu medical inovator, utilizat \u00een tratamentul anumitor afec\u021biuni oftalmologice. Prin aceast\u0103 tehnic\u0103, se utilizeaz\u0103 o surs\u0103 de lumin\u0103 laser de \u00eenalt\u0103 intensitate pentru a coagula \u021besuturile deteriorate sau anormale din ochi. 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