Post-Laser Treatment: Shadows and Concerns for High Myopia Patients

Q: Post-Laser Treatment: Shadows and Concerns for High Myopia Patients

Hello： 1. <br>Location of fluid accumulation： When fluid accumulation occurs after laser treatment, it is usually located beneath the retina. <br>Generally, this type of fluid accumulation does not directly lead to retinal detachment or necrosis. <br>2. <br>Resolution of fluid ac

Local shadowing after retinal laser treatment?

Hello Dr.
Gao, I am a patient with high myopia and have been regularly undergoing fundus examinations.
Three days ago, I was diagnosed with a retinal tuft in the lower nasal quadrant of my right eye, and I underwent preventive retinal laser treatment.
After the laser treatment, I noticed a small shadow in the upper outer part of my right eye (it feels like a small spot that I can catch a glimpse of in my peripheral vision, but it disappears when I look closely).
The day after the procedure, the shadow was still present, so I returned to the clinic early.
The doctor mentioned that there is some fluid accumulation at the site of the laser treatment, but no new lesions were observed.
I would like to ask Dr.
Gao:
1.
After laser treatment, where does the fluid accumulation typically occur? Is it beneath the retina? Could this lead to retinal detachment or necrosis?
2.
Will the fluid accumulation resolve on its own? How long does it usually take to dissipate?
3.
Is it generally recommended to treat a retinal tuft with laser immediately, or can it be monitored instead? (I am concerned about the recurrence of retinal tufts.)
4.
I am currently 8 months pregnant.
I would like to know if patients with high myopia are at risk of retinal tears or detachment during the labor process due to excessive straining.
Would a cesarean section be recommended?
I apologize for the multiple questions, and thank you, Dr.
Gao!

echo, 30~39 year old female. Ask Date: 2024/01/17

Dr. Gao Pilin reply Ophthalmology

Hello: 1.
Location of fluid accumulation: When fluid accumulation occurs after laser treatment, it is usually located beneath the retina.
Generally, this type of fluid accumulation does not directly lead to retinal detachment or necrosis.
2.
Resolution of fluid accumulation: The time for fluid resolution varies depending on individual circumstances and may take some time.
The doctor may recommend regular follow-up examinations to ensure that the situation resolves in a timely manner.
3.
Treatment of retinal tuft: A retinal tuft is typically a phenomenon where the retina is pulled by the vitreous, which may potentially cause a retinal tear.
When the physician assesses that there is a risk, laser treatment may be recommended to prevent further issues.
The decision for treatment usually depends on the nature of the lesion and the overall condition of the patient.
4.
Ophthalmic considerations during pregnancy: During pregnancy, female patients may face some specific ophthalmic considerations.
Hormonal changes and weight fluctuations during pregnancy may have some effects on the retina.
Additionally, with high myopia, there is an increased risk of retinal rupture; therefore, the mode of delivery should be jointly assessed by your obstetrician and ophthalmologist to ensure the best outcome.
Of course, if solely considering the risk to the retina, cesarean delivery may be an option.

Reply Date: 2024/01/17

More Info

Understanding the implications of post-laser treatment, especially for high myopia patients, is crucial for managing expectations and ensuring optimal eye health. After undergoing laser treatment for a retinal tuft, it is common to experience some residual effects, such as shadows or black spots in your vision. Here’s a comprehensive overview addressing your concerns:
1. Location of Fluid Accumulation: After laser treatment, any fluid accumulation typically occurs beneath the retina, known as subretinal fluid. This is a common occurrence and is usually a result of the laser's effect on the retinal tissue. While the presence of this fluid can be alarming, it does not inherently lead to retinal detachment or necrosis. The body often reabsorbs this fluid over time, and it is essential to monitor the situation through regular follow-ups with your ophthalmologist.

2. Resolution of Fluid Accumulation: The duration for the subretinal fluid to resolve can vary significantly among individuals. In many cases, it may take several weeks to a few months for the fluid to dissipate completely. During this time, it is crucial to maintain regular check-ups to ensure that the condition is improving and that no new complications arise.

3. Management of Retinal Tufts: Retinal tufts are areas of abnormal retinal tissue that can potentially lead to more severe issues, such as retinal tears or detachment. The decision to treat a retinal tuft with laser therapy often depends on its characteristics and the patient's overall risk factors. In some cases, observation may be appropriate, especially if the tuft is small and not causing any symptoms. However, if there is a concern about the potential for complications, laser treatment is typically recommended as a preventive measure.

4. Pregnancy and High Myopia: As a high myopia patient, you may have an increased risk of retinal complications during pregnancy and childbirth. The physical strain of labor, particularly if you are pushing hard, can theoretically increase the risk of retinal tears or detachment. Therefore, it is essential to discuss your delivery options with both your obstetrician and ophthalmologist. While vaginal delivery is possible for many women with high myopia, some may be advised to consider a cesarean section (C-section) to minimize the risk of complications.

5. Monitoring and Follow-Up: Regular eye examinations are vital for anyone with high myopia, especially after undergoing laser treatment. Your ophthalmologist will likely recommend follow-up appointments to monitor your retinal health and ensure that any changes are addressed promptly. Adhering to these recommendations can help alleviate concerns and provide peace of mind.

In conclusion, while experiencing shadows or black spots after laser treatment can be concerning, it is often a temporary condition related to fluid accumulation. Regular monitoring and communication with your healthcare providers are essential in managing your eye health effectively. If you have any further questions or concerns, do not hesitate to reach out to your ophthalmologist for personalized advice and reassurance.

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