In an area between 2 lesions, we observed an undisturbed photoreceptor mosaic of 82 819 rods/mm cones/mm 2. The mean (SD) size of 20 lesions on AOSO was 92.0 (10.9) μm, with substantial variability in their appearance ( eFigure 2). Photoreceptor disturbances appeared to correspond to the area of laser application and not beyond it. On AOSO, circular zones of hyporeflectivity with uniform absence of photoreceptors corresponded to laser lesions observed by SD-OCT and color fundus photographs. The correlation between B-scan and C-scan SD-OCT images, color fundus photographs, and an AOSO montage of the photoreceptors in the area of macular grid laser treatment was determined ( Figure 1A-D and Figure 2). The AO imaging was successful after edema regressed. Institutional review board approval was obtained. The Pascal system delivered evenly spaced laser applications with clinical precision, facilitating our investigation in these patients. For calibration of all retinal images, axial length was measured using an IOLMaster (Carl Zeiss Meditec). Subject 2 was a 43-year-old woman with proliferative diabetic retinopathy treated with panretinal laser photocoagulation consisting of 4 × 4 grid arrays with a 200-μm spot diameter and 200-μm spacing using 425 mW of power and a 20-millisecond duration to produce lesions of moderate intensity ( eFigure 1). Treatment consisted of 3 × 3 grid laser applications with a 100-μm spot diameter and 100-μm spacing using 100 mW of power and a 20-millisecond duration to produce barely visible lesions clinically. Subject 1 was a 57-year-old woman with macular edema from hemicentral retinal vein occlusion. Two patients received short-duration (20-millisecond) Pascal laser therapy (532 nm OptiMedica Corp) for clinical indications. Shared Decision Making and Communication.Scientific Discovery and the Future of Medicine.Health Care Economics, Insurance, Payment.Clinical Implications of Basic Neuroscience.Challenges in Clinical Electrocardiography.
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