Abstract
Purpose:
To evaluate the treatment outcome of 577nm subthreshold micropulse laser (SML) treatment for chronic central serous chorioretinopathy (CSC) with persistent subretinal fluid (SRF).
Methods:
This retrospective study included 38 eyes of 33 consecutive patients who were treated with a 577nm SML (Supra Scan, Quantel Medical) for chronic CSC with persistent SRF. Patients with any prior treatment within the last 3 months were excluded. A confluent SML treatment was performed at the leakage sites detected by fluorescein and indocyanine green angiography. Examinations before and after SML treatment included best corrected visual acuity (BCVA) and spectral domain optical coherence tomography (SDOCT).
Results:
20 eyes received one SML treatment, 18 eyes 2 treatments and 8 eyes 3 treatments. Mean follow-up after the first SML treatment was 5.5 months (1-11 months). At the last follow-up, in 9 eyes (24%) the SRF had dissolved completely and in 18 eyes (47%) the SRF was reduced. Eleven eyes (29%) showed no improvement. The central retinal thickness (CRT) decreased significantly after treatment (mean CRT before SML: 393±140 µm, after SML: 289±80 µm, p< 0.01) and BCVA showed a significant increase (p<0.05). No laser scars were detected after treatment. In the subgroup of PDT therapy resistant patients (n=21) with one or more half dose PDT treatments in the past, in 3 eyes (14%) the SRF had dissolved completely and in 12 eyes (57%) the SRF was reduced. Six eyes (29%) showed no improvement. The CRT decreased significantly after treatment (mean CRT before SML: 347±125 µm, after SML: 284±73 µm, p< 0.01) and BCVA showed a significant increase (p<0.05).
Conclusions:
The 577nm SML treatment is effective in the treatment of chronic CSC with persistent SRF. Even patients without improvement after PDT benefited from SML.