Comparison of photodynamic therapy and navigated microsecond laser for chronic central serous chorioretinopathy

Ntomoka, Cyprian Gabriel; Rajesh, Bindu; Muriithi, Gachago Muchai; Goud, Abhilash; Chhablani, Jay

doi:10.1038/s41433-018-0029-z

Cited by 20 publications

(20 citation statements)

References 36 publications

(48 reference statements)

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“…Ntomoka et al [60] showed that SML is superior in terms of efficacy to PDT (visual acuity improvement 0.12 vs. −0.02 (p = 0.039), SRF resolution 59% vs. 21.7%, CMT reduction 85.5 μm vs. 24.47 μm (p = 0.02), respectively, 6 months after treatment). Nevertheless, these outcomes have not been confirmed by PLACE trial results recently published by van Dijk et al [61]; in particular, a higher rate of SRF resolution after half-dose PDT treatment compared to SML treatment has been shown, both at the first post-treatment evaluation at 6-8 weeks (51.2% vs. 13.8%, p < 0.001) and after 8 months (67.2% vs. 28.8%, p < 0.001), despite the improvement in vision-related quality of life being similar for both treatments.…”

Section: Laser Treatmentsmentioning

confidence: 99%

Non-resolving, recurrent and chronic central serous chorioretinopathy: available treatment options

Sartini

Figus

Nardi

et al. 2019

Eye

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Central serous chorioretinopathy is one of the most frequent causes of vision reduction among middle-aged men. This disease usually has a self-limiting course, but sometimes it lasts more than 4-6 months or a second episode follows a complete resolution of the first one. Nevertheless, to date no consensus exists about the duration threshold and therapy protocols for these non-resolving central serous chorioretinopathy. Treatment as half-dose and half-fluence photodynamic therapy, subthreshold micropulse laser treatment, mineralocorticoid receptor antagonists, intravitreal anti-angiogenic drugs, transpupillary thermal therapy, anti-androgenic drugs, methotrexate, Rifampicin and melatonin are described in this review. Complications are very uncommon but end-point results like central macular thickness reduction and best-corrected visual acuity improvement are difficult to compare among different therapeutic modalities due to different duration of follow-up and lack of homogeneity in patient recruitment. The aim of this review is focusing on treatment modalities for these chronic forms with comprehensive recent management updates according to latest clinical trial results.

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Section: Laser Treatmentsmentioning

confidence: 99%

Non-resolving, recurrent and chronic central serous chorioretinopathy: available treatment options

Sartini

Figus

Nardi

et al. 2019

Eye

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“…Nevertheless, baseline CMT was better than other studies (290.5 µm vs 402 µm vs 326.5 µm vs 369 µm) which can explain the lower decrease in CMT. 7,12,14 Ntomoka et al 7 was the only study that evaluated macular layers besides CMT. In our study, SRF was also less severe than in other studies (26.5 µm vs 160.5 µm).…”

Section: Discussionmentioning

confidence: 99%

“…[4][5][6] Other available treatment options include mineralocorticoid antagonist (ie spironolactone and eplerenone), focal laser or anti-vascular endothelial growth factor (VEGF) therapy. [7][8][9] There is overall poor evidence for the use of systemic and intravitreal medications; mineralocorticoid receptor antagonists may have the greatest potential from this class of treatments. Conventional thermal photocoagulation may be used in selected cases.…”

Section: Introductionmentioning

confidence: 99%

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<p>532-nm Subthreshold Micropulse Laser for the Treatment of Chronic Central Serous Retinopathy</p>

Sousa¹,

Calvão-Santos²,

João³

et al. 2020

OPTH

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Introduction: Subthreshold micropulse laser treatment with a 532 nm (532-SML) wavelength has been suggested as a treatment option for the treatment of chronic central serous retinopathy (cCSR). The objective is to present its effects and complications. Methods: We present a retrospective cohort study of cCSR patients submitted to 532-SML. Best-corrected visual acuity (BCVA) and spectral-domain optical coherence tomography (SD-OCT) parameterscentral macular thickness, subfoveal outer nuclear layer, external limiting membrane, ellipsoid band, interdigitation band, subretinal fluid and choroidal thicknesswere evaluated before and 12 weeks after treatment. A power of 50%, a duty cycle of 5%, exposure time of 200 ms and a spot size of 160 µm were the applied laser parameters. Results: We included 26 eyes. Overall there were no significant changes in visual acuity (median 0.20 (IQR 0) logMAR before and after treatment) or SD-OCT parameters. However, visual benefits occurred in 42.3% (n=11) of the patients and in half of the cases, subretinal fluid was completely reabsorbed. There were no complications. Conclusion: In this study, 532-SML was overall ineffective on cCSR as it did not lead to significant changes in the overall median visual acuity and SD-OCT parameters. However, some patients may have benefited functionally and anatomically from the treatment; further investigation is necessary to understand the potential of 532-SML.

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“…Interestingly, a recent study compared PDT with navigated subthreshold laser in an albeit smaller study (45 eyes of 39 subjects). [ 59 ] Navigated laser was applied as confluent spots at areas of focal leakage identified on earliest phase of fluorescein angiography. Navigated laser appeared to be superior to PDT in improving both anatomic and visual function at 6 months.…”

Section: Considerations In Treatment Of Cscmentioning

confidence: 99%

Management of chronic central serous chorioretinopathy

Hanumunthadu

Tan

Singh

et al. 2018

Indian J Ophthalmol

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New treatment modalities for the management of central serous chorioretinopathy (CSC) now exist. While acute CSC generally resolves without the requirement for intervention, chronic CSC has been associated with persistent disruption in visual function. Current treatment approaches include photodynamic therapy, oral aldosterone antagonism and subthreshold multifocal laser. There has also been further investigation into a number of new treatments including antivascular endothelial growth factor treatment. Further investigation using developing optical coherence tomography imaging is helping to determine biomarkers of CSC activity, potential indicators of treatment response and indications of chronicity of disease activity. Further comparative study is required to determine the effectiveness of different forms of treatment in a range of patients with varied demographics, aetiology and chronicity of disease.

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Comparison of photodynamic therapy and navigated microsecond laser for chronic central serous chorioretinopathy

Abstract: nMSL seems to be superior over PDT in improving visual and anatomical outcomes at 6 months and can be considered as a cheap alternative to PDT in treatment of CSCR.

Cited by 20 publications

References 36 publications

Non-resolving, recurrent and chronic central serous chorioretinopathy: available treatment options

Non-resolving, recurrent and chronic central serous chorioretinopathy: available treatment options

<p>532-nm Subthreshold Micropulse Laser for the Treatment of Chronic Central Serous Retinopathy</p>

Management of chronic central serous chorioretinopathy

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