Functional and morphological outcome in patients with chronic central serous chorioretinopathy treated by subthreshold micropulse laser

Abstract

BackgroundChronic central serous chorioretinopathy is a serious therapeutic problem as it may lead to significant visual impairment. The aim of this retrospective study is to evaluate functional and morphological effects, as well as factors influencing visual outcome in patients treated by subthreshold micropulse laser.MethodsFifty-one eyes with chronic central serous chorioretinopathy lasting longer than 4 months (18 months on average) underwent up to two sessions of subtreshold micropulse laser treatment. Change in best corrected visual acuity, central retinal thickness, central retinal volume, average central retinal thickness and maximum subretinal fluid height were measured. Relation between the effects of the treatment and the initial retinal morphological and functional parameters was then analyzed.ResultsThe total resorption of subretinal fluid was achieved in 36 cases (70.6%). There was, however, only a minor improvement in best corrected visual acuity of approximately one line on the Snellen chart. No correlation was observed between the effects of the treatment and the duration of the symptoms, retinal morphology and initial visual acuity. Younger patients responded better to the therapy.ConclusionSubthreshold micropulse laser treatment in chronic serous chorioretinopathy provides good morphological results, however significant improvement of visual acuity is not to be expected.

Visual outcomes and anatomic changes after sub-threshold micropulse yellow laser (577-nm) treatment for chronic central serous chorioretinopathy: long-term follow-up

“…This was also reported in a recent study emphasizing younger patients responded better to therapy with 577 nm SMYL. 41 Although our findings suggest that 577 nm SMYL for CCSC is effective and safe, this new laser modality may not completely prevent the recurrence of CCSC with multiple leakage in older patients.…”

Subthreshold diode micropulse laser versus observation in acute central serous chorioretinopathy

“…This could again be indicative of the effect of laser in decreasing choroidal hyperpermeability through a mechanism not completely understood. Other studies have also shown that SDM laser decreases recurrences of CSC …”

“…Outer nuclear layer thinning at the central fovea should indicate cone photoreceptor loss, considering the distribution of rod and cone photoreceptors. Gawecki et al used SDM laser for treatment of chronic CSC and demonstrated that although the laser provided good morphological results, there was no significant improvement in visual acuity. They concluded that in order to achieve good visual results, SDM laser should be considered in acute cases.…”

<p>532-nm Subthreshold Micropulse Laser for the Treatment of Chronic Central Serous Retinopathy</p>

“…A greater visual acuity improvement and CMT reduction were observed during the first months after treatment in most of the studies. 4,14,19,20 For reference, 12 weeks seems to be enough to test the efficacy of this new wavelength in cCSR; this time frame has been used in other studies to understand the response and to weight other treatment options. 2,4,8,9,14,20 In our study, there were no significant changes in BCVA which seem inferior than the other studies that evaluated micropulse laser for cCSR.…”