Comparative evaluation of diode laser versus argon laser photocoagulation in patients with central serous retinopathy: A pilot, randomized controlled trial [ISRCTN84128484]

Abstract

BackgroundTo evaluate the efficacy of diode laser photocoagulation in patients with central serous retinopathy (CSR) and to compare it with the effects of argon green laser.MethodsThirty patients with type 1 unilateral CSR were enrolled and evaluated on parameters like best corrected visual acuity (BCVA), direct and indirect ophthalmoscopy, amsler grid for recording scotoma and metamorphopsia, contrast sensitivity using Cambridge low contrast gratings and fluorescein angiography to determine the site of leakage.Patients were randomly assigned into 2 groups according to the statistical random table using sequence generation. In Group 1 (n = 15), diode laser (810 nm) photocoagulation was performed at the site of leakage while in Group 2 (n = 15), eyes were treated with argon green laser (514 nm) using the same laser parameters. Patients were followed up at 4, 8 and 12 weeks after laser.ResultsThe mean BCVA in group 1 improved from a pre-laser decimal value of 0.29 ± 0.14 to 0.84 ± 0.23 at 4 weeks and 1.06 ± 0.09 at 12 weeks following laser. In group 2, the same improved from 0.32 ± 0.16 to 0.67 ± 0.18 at 4 weeks and 0.98 ± 0.14 at 12 weeks following laser. The improvement in BCVA was significantly better in group 1 (p < 0.0001) at 4 weeks. At 4 weeks following laser, all the patients in group1 were free of scotoma while 6 patients in group 2 had residual scotoma (p < 0.05). The mean contrast sensitivity in group 1 improved from pre-laser value of 98.4 ± 24.77 to 231.33 ± 48.97 at 4 weeks and 306.00 ± 46.57 at 12 weeks following laser. In group 2, the same improved from 130.66 ± 31.95 to 190.66 ± 23.44 at 4 weeks and 215.33 ± 23.25 at 12 weeks. On comparative evaluation, a significantly better (p < 0.001) improvement was noted in group 1.ConclusionDiode laser may be a better alternative to argon green laser whenever laser treatment becomes indicated in patients with central serous retinopathy in terms of faster visual rehabilitation and better contrast sensitivity. In addition, diode laser also has the well-recognized ergonomic and economic advantages.

Interventions for central serous chorioretinopathy: a network meta-analysis

“…We provided a summary describing each of the included studies in the Characteristics of included studies table. Thirteen of 25 included studies did not report either the number of eyes or number of participants enrolled; we assumed that all included studies were parallel RCTs, where only one eye per participant was enrolled (Bae 2011; Boscia 2008; Brancato 1994; Browning 1993; Chan 2006; Klatt 2011; Leaver 1979; Ontiveros-Orozco 2004; Rahbani-Nobar 2011; Sawa 2014; Shang 1999; Verma 2004; Zhang 2012). …”

Navigated focal laser photocoagulation for central serous chorioretinopathy

“…Since then, laser application to the site of leakage (direct laser photocoagulation) has become a commonly used treatment modality. Laser photocoagulation shortens the duration by 2 months and also reduces the recurrence rate with no change in the final visual outcome 4–7…”

Central Serous Chorioretinopathy Treatments: A Mini Review

“…Verma et al [32] compared the effects of a micropulse diode laser (810 nm) with standard argon laser photocoagulation in a randomized clinical trial. The study considered patients with acute CSC, with a symptom duration of less than 8 days and with a single focal leakage site.…”