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

Abstract

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.

Diagnosed a Patient with Central Serous Chorioretinopathy? Now What?: Management of Central Serous Chorioretinopathy

“…Scholz et al also performed a retrospective comparative study with 577 nm yellow microuplse NRT, comparing it against half-dose PDT in 100 patients with chronic CSCR. 59 Six weeks after treatment, both groups had a statistically significant decrease in CMT (−148µm, NRT; −76µm, PDT) with 36% of eyes in the NRT group showing complete resolution of fluid as compared to 21% in the PDT group. Kretz et al performed a prospective randomized control study that compared SDM with half-dose PDT and observational control among 62 chronic CSCR patients.…”

Yellow (577 nm) micropulse laser versus half-dose verteporfin photodynamic therapy in eyes with chronic central serous chorioretinopathy: results of the Pan-American Collaborative Retina Study (PACORES) Group

“…In a similar study to ours, Scholz and colleagues13 compared the short-term outcomes of eyes treated with yellow MP laser with eyes treated with half-dose PDT. They reported that at 6 weeks, both half-dose PDT and yellow MP laser were effective for chronic CSCR.…”

“…Our results in general were much more favourable in both the MP laser and PDT arms. The patients in the series of Scholz et al 13 had a mean duration of disease of 4 years.…”

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

“…[28,29] Those inconsistences may be a consequence of different characteristics of the study groups, especially in regard to the duration of the disease and baseline visual acuity. Studies directly comparing SMPLT and PDT in the treatment of chronic CSCR generally do not favor any of these therapies and reveal moderate BCVA improvement (a few ETDRS letters) similar in both groups [30,31,32]. Only large PLACE trial shows significantly better morphological results with PDT treatment and moderately better visual outcome compared to SMPLT ( + 6.78 ETDRS letters versus +4.48 ETDRS letters at 7 months).…”