Functional Outcomes and Safety Profile of Trans-Foveal Subthreshold Micropulse Laser in Persistent Central Serous Chorioretinopathy

Abstract

Our study evaluated visual function changes after subthreshold micropulse laser (SML) treatment in persistent central serous chorioretinopathy (CSC) and SML safety profile. We conducted a prospective study including 31 fovea-involving CSC patients. The natural course was observed for the first 3 months, SML was performed at 3 months, and SML effectiveness was observed at 6 months. At all three clinical visits, optical coherence tomography (OCT), best corrected visual acuity (BCVA), contrast sensitivity (CS) in five spatial frequencies (1.5, 3.0, 6.0, 12.0, and 18.0 cycles per degree (cpd)), microperimetry (MP), and multifocal electroretinography (mfERG) were performed. The SML safety profile was evaluated with functional and morphological parameters. In the cohort of all CSC patients treated with SML, the statistically significant average improvement was observed in BCVA (p = 0.007), CS-1.5 (p = 0.020), CS-3.0 (p = 0.050), CS-12.0 (p < 0.001), CS-18.0 (p = 0.002), CS (CS-A) (p < 0.001), MP in the central ring (MP-C) (p = 0.020), peripheral ring (MP-P) (p = 0.042), and average retinal sensitivity (MP-A) (p = 0.010). After the SML treatment, mean changes in mfERG amplitudes and implicit times in our cohort were not statistically significant. No morphological or functional adverse effects of SML treatment were observed. SML treatment in persistent CSC episodes leads to significant functional improvement and has an excellent safety profile.

Panmacular Micropulse Laser Treatment of Central Serous Chorioretinopathy: Two-Year Follow-Up of Morphological and Functional Parameters

“…However, our study is the first to monitor pachyvessel diameter during MPLT treatment. Notably, the treatment was completely safe, as no damage to the RPE after the laser procedure was found at fundus autofluorescence (FAF), consistent with prior studies [4,9,12,13,[18][19][20].…”

“…However, in these cases, total SRF resolution was achieved only in 48.4% of CSC cases lasting three months [13]. The treatment significantly improved mean BCVA, especially in patients with a complete reduction of SRF, during the six-month follow-up period [12], [13]. After a two-year follow-up, we also found that the treatment was the most effective for patients suffering from acute CSC.…”

“…Similarly, Kiraly et al limited laser therapy to the area of the neurosensory retinal detachment. However, in these cases, total SRF resolution was achieved only in 48.4% of CSC cases lasting three months [13]. The treatment significantly improved mean BCVA, especially in patients with a complete reduction of SRF, during the six-month follow-up period [12], [13].…”

“…Recently, transfoveal MPLT therapy was introduced as a treatment for acute CSC, but different results were obtained [12,13].…”