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Alessandro J R Dare, Renato Peroni, Fernando Paganelli, Leonardo C Castro; Micropulsed Laser Therapy Outcomes in the Treatment of Chronic Central Serous Choroidopathy Based on Leakage Pattern. Invest. Ophthalmol. Vis. Sci. 2014;55(13):6385. doi: https://doi.org/.
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© ARVO (1962-2015); The Authors (2016-present)
Report the functional and anatomic outcomes of a therapeutic possibility using a foveal selective 810-nm micropulsed laser therapy (MLT) technique for chronic idiopathic central serous chorioretinopathy (ICSC) with diffuse or foveal leakage.
Thirty-eight eyes from thirty-six patients with ICSC with symptoms duration longer than 6 months with foveal or juxtafoveal focal leakage (FL), or diffuse retinal pigment epithelial decompensation with multiple (ML) or indeterminate leakage (IL) involving or not the foveal area were treated. High-density focal and macular grids were delivered targeting the angiographic leakage points as well as the adjacent normal retina. Main outcomes were change in ETDRS best correct visual acuity and central macular thickness measured using optical coherence tomography. All patients were followed for at least 6-months. Pre and post-treatment fluorescein angiogram (FA) were accessed.
Twenty eyes (53%) were classified as FL, 9 (23,5%) as ML and 9 (23,5%) as IL. All eyes but one (95%) with FL showed complete fluid resolution after the MLT applied just at the leakage point strengthened by more laser in a grid pattern. Eight eyes (28.5%) needed two treatment sessions. Ten eyes gained more than three lines in visual acuity. In ML group 78% of the eyes had complete fluid resolution. The eyes with IL were the most difficult to respond to treatment, 78% needing re-treatments (7 of 9 eyes). Two eyes received one re-treatment, three received two re-treatments and two eyes received four re-treatment. The visual acuity did not change in 5 eyes, increased one line in two eyes and increased two lines in two eyes with IL. No signs of retinal injure were detected even in that eyes receiving 5 treatment sessions.
MLT showed to be an effective therapeutic technique in Chronic CSC. IL have the worst outcome in response to MLT, similar to others therapeutic approaches, however re-treatments could be performed as necessary due to the absence of retinal damage, scarring, inflammation, and associated complications, enhancing the final outcomes in this challenging CSC subtype.
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