Dr Netan Choudhry

‘Voyage’, a study led by Dr Netan Choudhry at Vitreous Retina Macula Specialists of Toronto, has demonstrated that YAG (yttrium aluminium garnet) laser vitreolysis resolved vitreous opacities (floaters) in 35 patients.

Patients required two sessions on average, and outcomes were evaluated by pre- and post-treatment measurement of best corrected visual acuity (BCVA) and swept-source optical coherence tomography (OCT). After the final treatment, 90% of patients reported resolution of their visual disturbance and mean BCVA was significantly improved.

Presenting the findings at the 2020 virtual American Society of Retina Specialists meeting, Dr Choudhry said, “What was unique about our study was that we used OCT imaging, particularly swept-source of the vitreous, which is a little bit of a leap forward, to actually identify the opacity that the patients were complaining about. We then titrated the treatment to the endpoint of the disappearance of those opacities.”

The study’s co-author Dr Collier Jiang, from the University of Calgary, said that by increasing the gain to 75% from an unaltered swept-source OCT scan, previously invisible opacities became visible. “When the depth is increased to 6mm, we can identify some vitreous opacities that may have been missed with the standard 3mm depth.”

Dr Choudhry pointed out that YAG laser vitreolysis is not suited to all patients with floaters. Ideal candidates are those with a single, focal visible opacity residing in the central field of view, he said, adding that for amorphous opacities or multiple diffuse floaters, vitrectomy remains the only option.