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G. Lo Giudice, V. de Belvis, G. Prosdocimo; Subthreshold Transpupillary Thermotherapy For Serous Macular Detachment In The Chronic Central Serous Chorioretinopathy . Invest. Ophthalmol. Vis. Sci. 2006;47(13):3242.
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to report the use of subthreshold transpupilllary thermotherapy (TTT) in treating serous detachment of the neurosensory retina in the chronic central serous chorioretinopathy (CCSC).
noncomparative, nonrandomized, retrospective interventional case series. Seven eyes of 5 symptomatic patients with chronic CCSC and persistent serous detachment of the neurosensory retina with a clinical course between 24 and 60 months were studied. Pre–treatment visual acuity ranged between 20/70 to 20/500. The patients were treated with modified TTT and evaluated by fluorescein angiography, indocyanine green angiography and optical coherence tomography. Subthreshold treatment, with no visible end–point, was performed using an 810 nm diode laser with spot size of 2.0 mm, and power was set at 430 mW (low–dose). Treatment was given over the active leakage sites for 60 seconds. The follow–up period ranged from 6 to 12 months.
all eyes completed at least 6–month follow up. Compared to pre–treatment optical coherence tomography, an acute reduction in subretinal and intraretinal fluid accumulation, serous detachment and anatomical fovea restoration was noted in 5 eyes with incomplete resolution in the remaining 2 eyes (P = < 0.001). A dramatic improvement in visual acuity (six eyes) was also report during a mean follow–up of 9.6 months (P = < 0.001). No patient had any treatment–related side effects.
modified subthreshod TTT appears to have a beneficial effect in treating patients with chronic central serous chorioretinopathy with persistent central serous neurosensory detachment, by reducing subretinal fluid accumulation, and serous detachment with resultant improvement in vision. The encouraging results and lack of visually significant complications suggest that further investigation is warranted.
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