Morphological parameters predicting subthreshold micropulse laser effectiveness in central serous chorioretinopathy

Kiraly, Peter; Smrekar, Jaka; Mekjavič, Polona Jaki

doi:10.1007/s10103-022-03574-4

Cited by 10 publications

(14 citation statements)

References 37 publications

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“…15 Moreover, decreasing number of HF at the fovea was associated with a good response to the SML treatment. 33 We observed similar findings in our study, as the higher number of HF around the fovea and around the leaking PED was associated with pCSC.…”

Section: Discussionsupporting

confidence: 90%

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Biomarkers predicting central serous chorioretinopathy episode persistence

Kiraly

Smrekar

Mekjavič

2022

European Journal of Ophthalmology

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Purpose The purpose of this study was to identify biomarkers at presentation that are associated with a persistent central serous chorioretinopathy (CSC) episode. Methods The prospective study included 35 patients with an acute CSC episode. Potential clinical and imaging biomarkers were evaluated at baseline and 3 months from the episode onset. As biomarkers age, sex, steroid use, episode recurrence, central retinal thickness (CRT), macular volume (MV), choroidal thickness (CT), pigment epithelial detachment (PED) height, and width, number of retinal hyperreflective foci (HF), leakage pattern, and area of retinal pigment epithelial (RPE) alterations were investigated. Results At 3 months from the CSC episode onset, spontaneous resolution occurred in 19 patients, while 16 patients had a persistent CSC episode. The group of patients with a persistent episode was statistically significantly associated with female sex (p = 0.032), older age (p = 0.015), wider PED (p = 0.005), and higher number of HF (p = 0.02). Moreover, this group of patients had a significant association with thinner choroid and diffuse RPE alterations as a pair (p = 0.008). Conclusions Older and female CSC patients with wider PED, increased number of HF, thinner choroid, and diffuse RPE alterations at presentation are inclined to episode persistence and could benefit from earlier treatment.

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Section: Discussionsupporting

confidence: 90%

“…This is in concordance with other studies showing association between widespread RPE epitheliopathy and chronic CSC. 1, 19 Wider PED is known to be associated with a less favourable response to the PDT 32 and the SML 33 treatment. Moreover, if diffuse leakage on FA was noted, a less favourable response to SML was reported.…”

Section: Discussionmentioning

confidence: 99%

Biomarkers predicting central serous chorioretinopathy episode persistence

Kiraly

Smrekar

Mekjavič

2022

European Journal of Ophthalmology

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“…In particular, Kiraly et al demonstrated the amount of SRF to be an important biomarker in predicting treatment response by observing worse outcomes in cases with greater SRF [ 82 ]. They also investigated the role of pigment epithelium detachments (PEDs), concluding that wider PEDs correlated with poor response to YSML [ 82 ].…”

Section: Clinical Applicationsmentioning

confidence: 99%

Yellow Subthreshold Micropulse Laser in Retinal Diseases: An In-Depth Analysis and Review of the Literature

et al. 2023

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Yellow subthreshold micropulse laser (YSML) is a retinal laser capable of inducing a biologic response without causing thermal damage to the targeted tissue. The 577-nm YSML is delivered to the retina abiding by different protocols in which wavelength, power, duration, spot size and number of spots can be properly set to achieve the most effective and safe treatment response in various chorioretinal disorders. The ultrashort trains of power modulate the activation of the retinal pigment epithelium cells and intraretinal cells, such as Müller cells, causing no visible retinal scars. Subthreshold energy delivered by YSML stimulates the production of the heat-shock proteins, highly conserved molecules that protect cells against any sort of stress by blocking apoptotic and inflammatory pathways that cause cell damage. YSML treatment allows resorption of the subretinal fluid in central serous chorioretinopathy and intraretinal fluid in various conditions including diabetic macular edema, postoperative cystoid macular edema and other miscellaneous conditions. YSML also seems to modulate the development and progression of reticular pseudodrusen in dry age-related macular degeneration. The aim of this review is to discuss and summarize the safety and efficacy of YSML treatment in retinal diseases.

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“…The height of SRF was measured as the maximum vertical distance between the outermost hyper reflective line of the neurosensory retina and the innermost hyper reflective RPE line by B-scan of macular. 8 Choroid thickness (CT) was calculated under the fovea by EDI B-scan of macular. Hyper reflective foci (HRF) was divided into outer segment of photoreceptor HRF and intraretinal HRF according to the location ( Figure 1 ).…”

Section: Methodsmentioning

confidence: 99%

“…The number of HRF was determined by the horizontal B-scan through fovea of OCT (centered on fovea, 1500 μm temporally and nasally). 8 RPE alterations included rough RPE (only rough RPE without any other RPE alterations), flat irregularity PED, hyper reflective mass (HRM), and bulge PED ( Figure 2 ), and determined by macula volume mode of OCT.…”

Section: Methodsmentioning

confidence: 99%

Optical coherence tomography biomarkers as predictors of transition to chronic central serous chorioretinopathy after retinal laser photocoagulation

Huang

Zheng

Sun

et al. 2023

Therapeutic Advances in Chronic Disease

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Objectives: To explore the optical coherence tomography (OCT) biomarkers to predict the transition to chronic central serous chorioretinopathy (cCSC) after retinal laser photocoagulation. Methods: Patients enrolled in this study were from a 12-week clinical trial comparing the efficacy and safety of subthreshold micropulse laser (SML) with threshold conventional laser (TCL) for CSC and had extended follow-up for more than 1 year. They were divided into two groups, transited to cCSC group (cCSC group) and did not transited to cCSC group (non-cCSC group) according to fundus examination at the extended follow-up. Collect the best-corrected visual acuity (BCVA) and OCT characteristics of patients at baseline and 12 weeks after laser treatment. Results: Twenty-seven patients were enrolled (42.6 ± 7.7 years old), and duration of follow-up was 178.9 ± 88.8 (57.0–312.0) weeks. Nine patients (33.3%) were assigned to cCSC group, and the other 18 patients (66.7%) were assigned to the non-cCSC group. Twelve weeks after the laser treatment, subretinal fluid (SRF) of 15 patients (83.3%) in non-cCSC group and 5 patients (55.6%) in cCSC group absorbed completely; the height of SRF had statistical difference between two groups ( p = 0.035); rough RPE was less common in cCSC group ( p = 0.030); hyper reflective mass (HRM) was more common in cCSC group ( p = 0.024); more number of hyper reflective foci (HRF) in outer segment of photoreceptor layer were detected in cCSC group ( p = 0.035). From baseline to 12 weeks after laser treatment, the number of HRF in outer segment photoreceptor layer did not change significantly in cCSC group ( p = 0.665) but decreased significantly in non-cCSC group ( p = 0.000). A total of five patients suffered binocular CSC, three of them in the non-cCSC group occurred later than the other two in the cCSC group (129.9–278.3 weeks vs 96.1–114.9 weeks after baseline). Conclusion: SRF, rough RPE, HRM, and number of HRF in outer segment photoreceptor layer 12 weeks after laser treatment, and change in the number of HRF in outer segment photoreceptor layer from baseline to 12 weeks after laser treatment may predict the transition to cCSC.

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Morphological parameters predicting subthreshold micropulse laser effectiveness in central serous chorioretinopathy

Cited by 10 publications

References 37 publications

Biomarkers predicting central serous chorioretinopathy episode persistence

Biomarkers predicting central serous chorioretinopathy episode persistence

Yellow Subthreshold Micropulse Laser in Retinal Diseases: An In-Depth Analysis and Review of the Literature

Optical coherence tomography biomarkers as predictors of transition to chronic central serous chorioretinopathy after retinal laser photocoagulation

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