Puncturing He-Ne laser needle (in brief, laser needle): there is hollow needle (for puncturing into point), we insert very thready optical fiber in the needle so that laser can irradiate body inside.
Until to now, there are many domestic reports of treatment of central angiospastic retinitis given by laser on exterior part of body, but not many on interior part. From January to December 1988, we applied J.G.Z-1 Puncturing He-Ne Laser Apparatus designed by combination of Bethune Medical University with Jilin Laser Institute to treat 177 eyes with retinitis on 107 patients, medical result were satisfied, the result observation is in the following.
1 Data
There are totally 107 patients with 72 male and 35 female; youngest patient is 17 years old and oldest 49; shortest duration of disease is 1 week and longest 6 years with mostly 3 to 6 months; among 107 patients, 37 patients got retinitis on one side of eye and 70 on both sides; 46 eyes on teachers, 38 on students, 57 on cadres, 19 on workers, 12 on farmers, 5 on others.
Diagnosis and classification:
Diagnosis:
A: failing of vision, central dark points, smaller and deforming objects by vision.
B: Au reflective of macular center is weakened or disappeared, round or irregular edema on macular region or places around macular region, yellow or white spot or piece shape exudation after eye ground test.
Classification on stages: (we choose Li Jianchuan Stage Classification for clinical observation)
Stage 1 - Edema stage: turbidity or edema on macular region, Au reflective of macular center is disappeared.
Stage 2 - Exudation stage: turbidity or edema on macular region, yellow or white spot or piece shape exudation in different quantity and sizes.
Stage 3 - Recovery stage: stage 1 and 2 are relieved, but still pigment dysfunction with long time, or exudation with clear border. There are spontaneous symptoms including vision (or correction vision) below 1.0 and duration more than half year.
In our patients, 67 eyes (37.85%) on stage 1, 69 eyes (38.98 %) on stage 2 and 41 eyes (23.16%) on stage 3.
2 Treatment method
Points: primary points – Qiuhou, Binao (LI14); secondary point: Jingming (BL1), Taiyang.
Method: Turn on power, indicator light is on, focus tip of 2 milliwatts laser needle on one red point, disinfect needle with 75% alcohol for 10 minutes and ordinarily disinfect skin of point, puncture needle into point, retain needles 10 minutes after have qi arriving (soreness, numbness and distension), press dry cotton ball on point to prevent bleeding after withdraw needles. Treatment is once a day, 10 times are considered as one course, continue second course after 3 days break. Before treatment, it is necessary to test vision and eye ground. There is no other therapy except oral intake of vitamin during laser needle treatment.
3 Treatment result
A: Effect stages (we apply Li Jianchuan Stage Classification)
1): basically cured - vision above 1.0, edema on macular region is disappeared, no or only little exudation with clear border, spontaneous symptoms are basically stopped.
2): obvious effective - vision is improved (more than 4 lines improved on Visual Table), disorders on macular region are obviously relieved, and spontaneous symptoms are relieved.
3): improved - vision is improved (1 to 3 lines improved on Visual Table), spontaneous symptoms and disorders on macular region are relieved.
4): no effect - vision is not improved, also no improvement on spontaneous symptoms and eye ground.
B: Treatment result
Basically cured - 71%; obvious effective - 14.1%; improved - 10.2%; no effect - 4.5%.
Edema stage - 48 eyes basically cured; 8 obvious effective; 9 improved; 2 no effect.
Exudation stage - 46 eyes basically cured; 15 obvious effective; 5 improved; 3 no effect.
Recovery stage - 32 eyes basically cured; 2 obvious effective; 4 improved; 3 no effect.
C: Treatment reaction
Among 177 eyes from 107 patients, there is no side effect except subcutaneous bleeding on 3 eyes (bleeding is disappeared after two weeks given by warming therapy).
D: Follow-up observation
Follow-up 57 eyes from 43 patients. Shortest follow-up is two weeks and longest 6 months, 42 eyes keep same vision with vision after treatment, 13 eyes have better vision than vision after treatment and 2 eyes worse. So nearby effect stable, distal effect needs further observation.
4 Discussion
Puncturing He-Ne laser needle has following characteristics.
A: Laser needle directly punctures into points, which has the same functions with traditional needle.
B: Where needle tip goes, where laser needle can irradiate. Thermal effect, photochemical function and cohesive force given by laser needle can promote phagocytosis of WBC, activate growth of cells, increase protein activities, regulate qi and blood circulation on retinal region, absorb exudation and stop inflammation.
C: According to animals experiment, laser needle does not affect blood pressure, respiration, cardiac beats, blood circulation and cells gene, has no side effect of cancer. So this therapy is safe, reliable, easy and convenient and it can prevent scar on retinal region.
D: The disadvantage of this therapy:
Slightly painful when puncturing laser needle
Few patients got subcutaneous bleeding.
Key Words: central angiospastic retinitis, puncturing, He-Ne laser needle
Writer: Li Guisen
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