Transpupillary thermotherapy for subfoveal leaks in central serous chorioretinopathy

Abstract

Aim To evaluate transpupillary thermotherapy (TTT) for the treatment of subfoveal focal leaks in central serous chorioretinopathy (CSC). Methods The patients presenting with long-standing CSC, but without the features of chronicity, were offered the options of TTT, photodynamic therapy (for subfoveal leaks), photocoagulation (for extrafoveal leaks), or observation. The patients who opted for TTT or observation were enrolled in this study. TTT was performed using a spot diameter of 0.5 mm for 1 min. Best-corrected visual acuity (BCVA), status of macular detachment, and fluorescein angiographic status were evaluated at 1, 3, and 6 months. Results This study included 39 patients (40 eyes) with CSC between 4 and 12 months, of whom 25 patients (25 eyes) opted for TTT for subfoveal leaks. Fourteen patients (15 eyes) were followed up without treatment. The groups were comparable in age, sex, and baseline BCVA. Minimum follow-up was 6 months. Within 3 months, TTT resulted in the resolution of the serous detachment in 24 (96%) eyes with a single session; one eye required a repeat treatment. Eight control eyes demonstrated persisting CSC at the last follow-up. Visual acuity improved in 23 (92%) treated and five (33%) control eyes; the difference in outcome was statistically significant (Po0.001). One case developed choroidal neovascularization, which resolved with visual recovery to 20/20 after repeat-TTT. Conclusion TTT resulted in the resolution of CSC with subfoveal angiographic leaks with significant improvement in visual outcome, in comparison to the natural history of persistent CSC.

Lack of positive effect of intravitreal bevacizumab in central serous chorioretinopathy: meta-analysis and review

“…[7][8][9] CSC has a high spontaneous remission rate, but there is evidence of the benefit of early treatment. [10][11][12] CSC with single, extrafoveal leaking point can be treated using focal photocoagulation to shorten the duration of symptoms without altering the final visual outcomes and the recurrent rate. [13][14][15] This method, however, has a significant adverse effect such as symptomatic scotomas, secondary choroidal neovascularization (CNV), and so on.…”

Treatment of Central Serous Chorioretinopathy (Csc) Using Diclofenac through Different Routes of Administration, a Comparative Study

“…Central serous chorioretinopathy can leads to visual loss because of the accumulation of fluid in retinal layers for longer time that may leads to foveal attenuation, cystoid macular degeneration, and damage of the foveal photoreceptor layer [14][15][16] some therapeutic intervention may be helpful to resorb this fluid quickly and avoid dyschromatopsia and metamorphopsia along with other visual problems. Variety of treatment modalities like focal argon photocoagulation, PDT, anti-VEGF, topical nonsteroidal anti-inflammatory drug (NSAID) are being used.…”

Role of Transpupillary Thermotherapy in Central Serous Chorio-Retinopathy

“…Shukla et al [7], applied TTT to cases of chronic CSCR with subfoveal leaks and noted resolution of subretinal fluid in 96% cases following single round of treatment with improvement of visual acuity in 92% cases. Hussian et al [8], had mixed outcome with resolution of subretinal fluid occurring only in 64% cases.…”