Short-term efficacy of subthreshold micropulse yellow laser (577-nm) photocoagulation for chronic central serous chorioretinopathy

Kim, Ju Young; Park, Han Sang; Kim, Si Yeol

doi:10.1007/s00417-015-2965-7

Cited by 62 publications

(37 citation statements)

References 36 publications

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“…More than 60% of our patients had a disease duration of 41 year. Moreover, some studies show a slightly higher increase in BCVA after SML 17,23 and PDT 13,15,29 compared with our results. This could be attributed to the relatively low BCVA in our patients at baseline.…”

Section: Discussionsupporting

confidence: 56%

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Comparison of subthreshold micropulse laser (577 nm) treatment and half-dose photodynamic therapy in patients with chronic central serous chorioretinopathy

Scholz

Altay

Fauser

2016

Eye

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Purpose To compare the short-term treatment outcome of the 577 nm subthreshold micropulse laser (SML) and half-dose photodynamic therapy (PDT) in patients with chronic central serous chorioretinopathy (cCSC) and persistent subretinal fluid (SRF). Methods This retrospective study included 100 eyes of 100 consecutive patients who were treated with the 577 nm SML (Supra Scan, Quantel Medical) (n = 42) or half-dose PDT (n = 58) for cCSC. The treatment was applied at the leakage sites in the fluorescein and indocyanine green angiography. The treatment success was evaluated 6 weeks after treatment using best-corrected visual acuity, central retinal thickness, and resolution of SRF in spectral domain optical coherence tomography. Results Patients showed treatment response more often in the SML group compared with the PDT group (treatment response after SML: 33 eyes (79%), PDT: 34 eyes (59%), P = 0.036, χ 2 test). The CRT decreased significantly after both treatments (mean CRT before SML: 445 ± 153 μm, after SML: 297 ± 95, Po0.001; mean CRT before PDT: 398 ± 88 μm, after PDT: 322 ± 93 μm, Po0.001, Wilcoxon's signed-rank test). The decrease in CRT was statistically significantly higher in the SML group (decrease in CRT after SML: − 148 ± 163 μm, after PDT: − 76 ± 104 μm, P = 0.041, Mann-Whitney U-test). Conclusions Both the half-dose PDT and the 577 nm SML are potent treatments for cCSC with persistent SRF. More patients showed treatment response to the SML treatment and SML leads to a greater decrease in CRT.

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Section: Discussionsupporting

confidence: 56%

“…The idea is that retinal damage is not needed to acquire a therapeutic effect. 16 Studies with a 810 nm micropulse diode laser [17][18][19][20][21] and a 577nm micropulse laser 22,23 showed efficacy in CSC patients with subfoveal and extrafoveal leakage sites.…”

Section: Introductionmentioning

confidence: 99%

Comparison of subthreshold micropulse laser (577 nm) treatment and half-dose photodynamic therapy in patients with chronic central serous chorioretinopathy

Scholz

Altay

Fauser

2016

Eye

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“…However, the comparison of results between the different investigations is awkward, mainly due to the heterogeneous inclusion criteria, the laser setting and the area of application of the laser spots [33,34,35,36,37,38,39,40,41,42,43]. The studies consider acute CSC forms with symptom durations lasting a few days or less than 1 month as well as chronic forms with a duration range of 3-6 months.…”

Section: Treatment Optionsmentioning

confidence: 99%

Central Serous Chorioretinopathy Treatments: A Mini Review

et al. 2015

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Central serous chorioretinopathy (CSC) is a retinal disorder that primarily affects young (20- to 50-year-old) white men, although it is seen occasionally in older patients and females. CSC is characterized by avascular focal leakage through the retinal pigment epithelium (RPE), resulting in serous detachment of the neurosensory retina. The course is usually self-limiting and in most cases resolves spontaneously within a 3-month period, with visual acuity usually recovering to 20/30 or better. However, chronic CSC may develop as a consequence of recurrences or persistent neurosensory detachment, and can result in progressive RPE atrophy and permanent visual loss. A primary involvement of the RPE and choroidal vascularization play a significant role in the pathogenesis of CSC and the current treatment options attempt to restore the functions of the RPE and the normal choroidal vasculature. The aim of the current review is to provide an overview of the current therapeutical approaches to CSC, including observation, laser treatment, photodynamic therapy with verteporfin, intravitreal anti-vascular endothelial growth factor therapy and the mineralocorticoid receptor antagonists.

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“…Thus far, the medical literature on the subject concentrates predominantly on discussing the effects of treatment of CSCR. [15,16,17,18,19] Previous authors have suggested varying amounts of reduction of retinal edema and improvement in BCVA; however, the final results usually include cases with insufficient responses to SMPLT-that is, patients with persisting SRF-as well. Moreover, final CRT and BCVA values were not referred to the measurements in healthy individuals.…”

Section: Discussionmentioning

confidence: 99%

“…One of the recent advances in treating CSCR is subthreshold micropulse laser therapy (SMPLT), which is effective in terms of resolution of SRF; however, in CCSCR, this treatment elicits only a moderate improvement of visual acuity. [15,16,17,18,19] Furthermore, the complete resolution of SRF after many months or years of active disease does not necessary mean a restoration of normal vision or normal retinal morphology will occur. To our knowledge, this damage has not yet been precisely assessed in the medical literature; thus, our study sought to evaluate functional and morphological impairments in the retina in long-standing but resolved CCSCR following SMPLT.…”

Section: Introductionmentioning

confidence: 99%

Impairment of visual acuity and retinal morphology following resolved chronic central serous chorioretinopathy

Gawęcki¹,

Jaszczuk-Maciejewska²,

Jurska-Jaśko³

et al. 2019

Preprint

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Purpose Central serous chorioretinopathy(CSCR) is a complex ocular entity that, in its chronic form, can lead to serious visual impairment and morphological damage to the retina. The aim of the current retrospective study was to evaluate the damage present after long-standing but resolved central serous chorioretinopathy and refer it to healthy individuals. Correlations between measurable factors—for example, duration of the disease, baseline retinal morphological parameters, or patient age and/or their degree of impairment—were also assessed. Materials and methods The study group consisted of thirty-two eyes (13 female and 19 male, mean age 49.6 years SD +/- 10.5) with chronic central serous chorioretinopathy ( mean duration 18.9 months SD +/- 15.4) in which complete resolution of subretinal fluid was achieved after subthreshold micropulse laser treatment. Inclusion criterion was a lack of subretinal fluid within the whole area of the central retina scanned by the spectral domain optical coherence tomography. The group was extracted out of 51 cases of chronic CSCR that were treated with that method. They were analyzed according to final best-corrected visual acuity and retinal morphological parameters as measured by spectral optical coherence tomography with angiography option (OCTA). Results were compared with the outcomes of a control group, which consisted of 40 eyes of healthy individuals with full distance visual acuity (0.0 logMAR, 1.0 Snellen) never treated with subthreshold micropulse laser. Statistical analysis included regarding correlation between final visual acuity and final central retinal thickness and retinal and functional parameters prior to treatment. Results Final best-corrected visual acuity after chronic central serous chorioretinopathy was 0.23 logMAR (0.6 Snellen) and central retinal thickness was 39.32 µm smaller than in controls. No correlation was found between final visual acuity and retinal thickness and duration of the disease, patient age, and baseline morphological retinal parameters. OCTA scans revealed impaired choriocapillaries flow signal even following resolution of the disease. Conclusion Chronic central serous chorioretinopathy is a potentially damaging clinical entity that results in serious visual impairment, retinal thinning, and choroidal flow defects. Further research is needed to determine precisely the timepoint of this damage.

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Short-term efficacy of subthreshold micropulse yellow laser (577-nm) photocoagulation for chronic central serous chorioretinopathy

Abstract: Subthreshold micropulse yellow laser photocoagulation showed short-term efficacy in treating chronic CSC without retinal damage. However, prospective, randomized, and comparative large-scale studies are needed to evaluate the efficacy and safety of this treatment.

Cited by 62 publications

References 36 publications

Comparison of subthreshold micropulse laser (577 nm) treatment and half-dose photodynamic therapy in patients with chronic central serous chorioretinopathy

Comparison of subthreshold micropulse laser (577 nm) treatment and half-dose photodynamic therapy in patients with chronic central serous chorioretinopathy

Central Serous Chorioretinopathy Treatments: A Mini Review

Impairment of visual acuity and retinal morphology following resolved chronic central serous chorioretinopathy

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