Subthreshold diode micropulse laser versus observation in acute central serous chorioretinopathy

Arora, Supriya; Sridharan, Preethi; Arora, Tarun; Chhabra, Mohit; Ghosh, Basudeb

doi:10.1111/cxo.12818

Cited by 38 publications

(35 citation statements)

References 39 publications

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“…A significant reduction in SRF volume was observed already during the first 3 months. This is consistent with previous studies reporting the applicability of subthreshold laser treatment in acute CSC [7,35,36] for providing a faster visual rehabilitation than the standard of care (observation).…”

Section: Discussionsupporting

confidence: 92%

Efficacy of nanosecond laser treatment in central serous chorioretinopathy with and without atrophy of retinal pigment epithelium

Kaymak

Funk²,

Fricke³

et al. 2020

Int J Retin Vitr

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Background: To evaluate the outcomes of subthreshold nanosecond laser treatment of chronic central serous chorioretinopathy (CSC) as a function of the severity of concomitant of retinal pigment epithelium (RPE) defects. Methods: This retrospective study compares data from 23 CSC diagnosed eyes with only mild RPE defects (group 1), 16 CSC eyes with moderate RPE defects (group 2), and 17 CSC eyes having severe RPE defects (group 3). After subthreshold treatment with the standard Ellex 2RT ™ nanosecond laser (Ellex Medical Lasers Ltd, Australia), changes in macular structure and levels of subretinal fluid (SRF) were assessed by OCT-SD, OCT-A, functional integrity of the retina was assessed by corrected distance visual acuity (CDVA) and microperimetry, each at baseline and 1, 3, 6, and 12 months after initial treatment; re-treatment took place in cases of persistent SRF pro re nata. Results: During the 12 months observation period, group 1 and 2 mostly required on initial and one re-treatment (1.9 ± 1.0 treatments; 1.9 ± 1.3 treatments). In contrast, group 3 was subject to three to four treatments (3.7 ± 1.5 treatments). 6 to 12 months after treatment, subretinal fluid (SRF) disappeared in 100% of the eyes of group 1 and in 76.9%, and 42.9% of the eyes of group 2 and group 3, respectively. Retinal sensitivity and CDVA improved in group 1 and 2, but did not change significantly in group 3 during the 12 months period. Conclusions: Subthreshold nanosecond laser treatment is an effective and safe method for the restoration of macular anatomy and sensitivity in acute and chronic CSC cases with only mild or moderate RPE defects. However, this laser treatment has very limited outcome in CSC eyes with more severe RPE defects.

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Section: Discussionsupporting

confidence: 92%

Efficacy of nanosecond laser treatment in central serous chorioretinopathy with and without atrophy of retinal pigment epithelium

Kaymak

Funk²,

Fricke³

et al. 2020

Int J Retin Vitr

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“…Other methods, such as intravitreal injection of anti-VEGF medications appeared to be unsuccessful in treating pure serous chorioretinopathy [37,55]. Oral mineralocorticoid pathway inhibitors are used as a support of invasive therapies; however, so far, there has been no consent regarding their efficacy in the treatment of chronic CSCR [27,56,57,58].…”

Section: Smplt In Cscrmentioning

confidence: 99%

“…However, with the advent of SMPLT, ophthalmologists have a safe, non-damaging tool to the retina for the treatment of CSCR. Arora et al compared the results of early treatment of CSCR with observation [58]. Patients who undergone SMPLT in the acute phase of CSCR had better final BCVA and better contrast sensitivity than the patients that were just observed.…”

Section: Smplt In Cscrmentioning

confidence: 99%

Micropulse Laser Treatment of Retinal Diseases

Gawęcki¹

2019

JCM

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Subthreshold micropulse laser treatment has been intensively used for selected retinal diseases in the last decade; however, the exact mechanism of the action of lasers in the subthreshold micropulse mode is not yet fully understood. This kind of treatment is safe and cheap, and contrary to classic laser photocoagulation, it leaves the retinal cells intact. A modern theory of micropulse laser interaction with retinal tissue and a possible explanation of this mechanism are presented in this review. The authors present all the relevant literature on the application of micropulse lasers in different retinal disorders. The efficacy of this treatment is analyzed on the basis of available studies and then placed in the perspective of other therapeutic methods that are used in retinal diseases.

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“…Arora et al showed that patients with acute CSCR in whom prompt SMPLT treatment was administered had better final BCVA and contrast sensitivity in comparison with patients with acute CSCR who were observed only. [52] Definitely, more research is needed to provide new recommendations for the treatment of both acute CSCR and chronic CSCR. It would be useful to more precisely indicate the position of SMPLT and photodynamic therapy (PDT) in the treatment of this disease, as these two methods are the most promising and seem to provide the best functional and morphological results.…”

Section: Discussionmentioning

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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Subthreshold diode micropulse laser versus observation in acute central serous chorioretinopathy

Abstract: SDM laser produces faster and superior visual rehabilitation without any adverse effects. It also reduces the chances of CSC going into chronicity and recurrence compared to the current standard of care (observation).

Cited by 38 publications

References 39 publications

Efficacy of nanosecond laser treatment in central serous chorioretinopathy with and without atrophy of retinal pigment epithelium

Efficacy of nanosecond laser treatment in central serous chorioretinopathy with and without atrophy of retinal pigment epithelium

Micropulse Laser Treatment of Retinal Diseases

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

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