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F. Bandello, P. Lanzetta, F. Furlan, A. Polito; Non Visible Subthreshold Micropulse Diode Laser Treatment of Idiopathic Central Serous Chorioretinopathy. A Pilot Study . Invest. Ophthalmol. Vis. Sci. 2003;44(13):4858.
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Purpose: To verify the efficacy of non visible subthreshold micropulse diode laser (810 nm) irradiation in the treatment of idiopathic central serous chorioretinopathy (ICSC). Methods: Upon completion of informed consent, 5 patients with ICSC for a total of 5 eyes were included in the study. Patients enrolled underwent ETDRS visual acuity (VA) examination, dilated ophthalmoscopy, fluorescein angiography (FA) and optical coherence tomography (OCT) before treatment and during follow-up. Laser treatment was delivered through a three mirror Goldmann lens to the area of dye leakage with a micropulse diode laser (Iris MedicalTM, OculightTM SLx). A continuous-wave test spot of 200 microns and 0.2 seconds exposure time with such power that mild retinal whitening was obtained, was placed at the posterior pole. Subsequently, a duty cycle of 10-15% was set such as no visible change at the retinal level was evident during and after irradiation. Multiple and repeated spots were placed over and adjacent to the area of retinal pigment epithelium (RPE) leak. Results: Mean follow-up was 4 months (range 2-6 months). Powers used ranged from 1 to 1.6 W. Mean number of spots placed during irradiation was 150. One month after laser treatment, dilated ophthalmoscopy, FA, and OCT showed resorption of subretinal fluid and resolution of retinal detachment. RPE leak resolved at FA and no evidence of RPE or retinal changes due to laser treatment were discernible at FA or fundus biomicroscopy. This outcome was maintained throughout the follow-up period. Median VA was 0.63 (range 0.5- 0.8) before treatment and 0.8 (range 0.63- 1.0) at the end of the follow-up. VA improved by one line in 3 patients and by two lines in 2 patients. Conclusions: Non visible subthreshold micropulse diode laser may have an efficacy in the treatment of ICSC. A randomized study with larger series is needed
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