Choroidal Detachment Following Multi-spot Double Frequency Nd-YAG Retinal Photocoagulation – A Case Report

Abstract

Introduction: Panretinal photocoagulation (PRP) remains the gold standard treatment for severe non-proliferative and proliferative diabetic retinopathy (PDR), as it reduces the risk of severe visual loss by more than 50%. In the conventional single-spot laser, the procedure involves the application of moderate-intensity burns of 200-500 microns, placed one spot-size apart to achieve a total of 1200-2000 applications in 2 or 3 sessions. The more advanced retina lasers like the Pattern Scan Laser (PASCAL) and the VITRA multi-spot laser are 532 nm frequency-doubled (Nd: YAG) solid-state lasers. These modern lasers enable the application of multiple laser burns in a rapid pre-determined sequence with reduced pulse duration (10-20 ms) to facilitate the PRP to be completed in a single sitting with lesser collateral tissue damage. Case Report: Though multi-spot lasers have significantly reduced the adverse events when compared with the conventional single-spot lasers, we report a case of rare adverse events (serous choroidal detachment) following PRP with the VITRA multi-spot double frequency NdYAG (532 nm) laser. Conclusion: Most of the serious choroidal detachments following PRP are self-limiting. We recommend complete retinal evaluation post laser procedure even with modern multisport laser to look for such adverse events.