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Feria Estephania; Subthreshold 577 nm micropulse laser for the treatment of Chronic Central Serous Chorioretinopathy (CCSC). Invest. Ophthalmol. Vis. Sci. 2017;58(8):5926.
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© ARVO (1962-2015); The Authors (2016-present)
To evaluate the effect of subthreshold micropulse laser (SMP) in eyes with CCSC.
A consecutive series of patients with CCSC who consulted to Asociacion para Evitar la Ceguera en Mexico who had undergone treatment with SMP yellow laser were retrospectively analyzed between September 2015 to October 2016. Patients with an idiopathic serous macular detachment of the neurosensory retina on optical coherence tomography (OCT) and with a focal or diffuse leak at the level of the RPE on FA were included.These patients had been observed for a minimum period of 3 months for spontaneous resolution and then given SMP yellow laser treatment. All patients had undergone BCVA, OCT and FA before laser therapy with SMP using a 577nm laser (Iridex,Mountain View,CA) with 5% duty cycle,power of 450 mW,exposure duration 200 ms,high density,and spot size of 200 μm,confluent applied to all areas of leakage or subretinal fluid.Laser was delivered using an automated grid to cover the whole macular area. It is important to emphazise that we noted that the maximal subretinal fluid height was not always central. Hence,we manually measured the maximal height of the fluid on the OCT images and used it to assess the treatment outcome. Clinical examination, OCT and FA were performed at 1 and 3 months after treatment.
12 eyes of 11 patients were included. All eyes responded to SMP treatment. The mean best-corrected visual acuity measured 6 months after laser treatment was 3.9 Snellen lines (P<0.015). Mean BCVA showed stabilization at 4 months after SMP. Mean foveal thickness improved from 340.50μm before SMP to 160.50μm after SMP (P<0.002, paired t-test). One patient required additional SMP. Average resolution of leakage was 3 months. There was no evidence of RPE or retinal damage on OCT or FA.
We have the largest consecutive series of patients in the literature treated with SDM. This therapy may be a useful treatment modality for idiopathic CCSC. Its inherent property of using less energy, and thus, minimizing chorioretinal disruption,is appealing. However,randomized controlled trials are needed to establish long-term efficacy and to identify which patients may benefit most from this treatment. SDM is in fact superior to alternative treatment approaches.
This is an abstract that was submitted for the 2017 ARVO Annual Meeting, held in Baltimore, MD, May 7-11, 2017.
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