Method and apparatus to identify and treat neovascular membranes in the eye
First Claim
1. A process for locating and treating an abnormality in the ocular vasculature of the fundus of the eye of a living body, said process comprising:
- a. injecting a first bolus of a fluorescent dye composition into the circulatory system of the living body;
b. allowing the first bolus to circulate through the body and through the ocular vasculature of the fundus;
c. detecting the presence of the first bolus of dye in the ocular vasculature by diffusely irradiating the fundus of the eye with light energy from a first laser thus causing dye present in the vasculature to fluoresce;
d. detecting the presence and location of the abnormality in the vasculature by examining the fluorescence in the vasculature and identifying at least one location (B) wherein the fluorescence differs from the fluorescence of the surrounding normal vasculature;
e. focusing light energy from a second laser on the location (B) of the detected abnormality;
f. injecting a second bolus of a second fluorescent dye composition into the circulatory system;
g. detecting the presence of the second bolus of dye in the ocular vasculature; and
h. applying light energy from a second laser to treat the detected abnormality.
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Accused Products
Abstract
The method and apparatus of the invention allow a neovascular membrane in the ocular vasculature of the fundus of the eye to be identified and treated while minimizing damage to the sensory retina. First a bolus of fluorescent dye is injected and allowed to circulate through the ocular vasculature. When the fundus is diffusely irradiated with laser energy, dye present in the vasculature fluoresces. A neovascular membrane is identified when a particular area of fluorescence differs from the fluorescence of the surrounding normal vasculature. To treat the neovascular membrane, a second laser is focused on the site of the membrane and a second bolus of fluorescent dye is injected. When the presence of the second injection of dye is detected, energy from the focused laser is applied to damage or destroy the neovascular membrane.
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Citations
26 Claims
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1. A process for locating and treating an abnormality in the ocular vasculature of the fundus of the eye of a living body, said process comprising:
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a. injecting a first bolus of a fluorescent dye composition into the circulatory system of the living body; b. allowing the first bolus to circulate through the body and through the ocular vasculature of the fundus; c. detecting the presence of the first bolus of dye in the ocular vasculature by diffusely irradiating the fundus of the eye with light energy from a first laser thus causing dye present in the vasculature to fluoresce; d. detecting the presence and location of the abnormality in the vasculature by examining the fluorescence in the vasculature and identifying at least one location (B) wherein the fluorescence differs from the fluorescence of the surrounding normal vasculature; e. focusing light energy from a second laser on the location (B) of the detected abnormality; f. injecting a second bolus of a second fluorescent dye composition into the circulatory system; g. detecting the presence of the second bolus of dye in the ocular vasculature; and h. applying light energy from a second laser to treat the detected abnormality. - View Dependent Claims (2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12, 13, 14, 15, 16, 17)
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18. A process for locating and treating an abnormality in the ocular vasculature of the fundus of the eye of a living body, said process comprising:
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a. continuously irradiating the fundus of the eye with low level laser irradiation in the range of 35 mW per cm2 of retina; b. injecting a first bolus of a fluorescent dye composition into the circulatory system of a living body; c. allowing the first bolus to circulate through the body and through the ocular vasculature; d. detecting the precise instant the presence of the first bolus of dye enters the ocular vasculature by detecting the first appearance of fluorescence in the fundus; e. operating the laser in a pulsed mode and at a high level of laser irradiation greater than 35 mW per cm2 of retina but less than 170 mW per cm2 ; f. acquiring successive images of the fundus with the passage of time as the dye moves through the fundus, using shuttered means for acquiring, while coordinating the laser pulse with the means for acquiring so that the images are acquired only during the laser pulse; g. continuously irradiating the fundus as in step a; h. detecting the presence and location of the abnormality in the vasculature by examining the fluorescence in the images and identifying at least one location (B) wherein the fluorescence differs from the fluorescence of the surrounding normal vasculature; i. focusing light energy from a second laser on the location (B) of the detected abnormality; j. injecting a second bolus of a second fluorescent dye composition into the circulatory system; k. detecting the presence of the second bolus of dye in the ocular vasculature; and l. applying light energy from a second laser to treat the detected abnormality.
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19. An apparatus for locating and treating an abnormality in the ocular vasculature of the fundus of the eye of a patient comprising:
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a fundus camera focused on the fundus of the eye of a patient; a first laser which diffusely irradiates the fundus and excites a first fluorescent dye composition in the ocular vasculature of the fundus, said dye composition provided by an intravenous injection of a first bolus to the patient; means for acquiring images of the fundus, said means for acquiring connected to the fundus camera; means for recording and analyzing the images to detect and locate the abnormality, said means for recording and analyzing connected to the image acquiring means; and a second laser focusing on the detected abnormality and applying treatment to the abnormality by exciting a second fluorescent dye composition present in the abnormality, said second dye composition provided by an intravenous injection of a second bolus to the patient; wherein said first and second lasers are independently focused on the fundus by and fired through the fundus camera. - View Dependent Claims (20, 21, 22, 23, 24, 25, 26)
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Specification