Selective Retina Therapy for Patients with Central Serous Chorioretinopathy in Japan

Abstract

Purpose: : To investigate the efficacy of sub-threshold laser treatment on retinal pigment epithelium named Selective Retina Therapy (SRT) for central serous chorioretinopathy (CSCR) of Japanese patients.

Methods: : Seven eyes of 7 CSCR patients consisting of 3 males and 4 females were treated. Mean age was 52 (range: 37-67). All patients had dye leakage on fluorescein angiography (FA) and persistent serous retinal detachment at the subfovea lasting morw than 3 months. SRT laser (frequency-doubled, pulse-stretched Nd:YLF laser; 527 nm, 1.7 µs pulse duration, 100-Hz repetition rate, Medical Laser Center Lübeck, Germany) was used for treatment. Following test irradiation to determine the threshold energy power, SRT treatment was performed at the leakage site. Best corrected visual acuity (BCVA) examination, FA and optical coherence tomography (OCT) were performed pre- and three months postoperatively. The extent of serous retinal detachment (SRD) was evaluated by measuring foveal thickness (FT) and macular thickness volume (MTV) with OCT.

Results: : The mean number of SRT laser irradiation was 3.1 (range 2-5) and the mean laser energy was 126 µJ (range 108-140 µJ). The mean logMAR BCVA improved from 0.17 preoperatively to 0.07 after 3 months (p=0.01). The mean FT and MTV were reduced from 322.0 µm and 0.25 mm3 preoperatively to 268.6 µm and 0.21 mm3 after 3 months (p=0.01, 0.01), respectively. The subfoveal SRD disappeared in 4 eyes, decreased in 1 eyes and remained in 2 eyes. The leakage on FA disappeared in 2 eyes, decreased in 2 eyes and remained in 2 eyes, except one patient with fluorescein allergy. There were no adverse events during the observation period.

Conclusions: : SRT seemed to be effective for resorption of SRD and improvement of BCVA in Japanese CSCR patients during the short follow-up periods. A prospective, randomized trial was warranted for the clinical evaluation of SRT.

Clinical Trial: : http://www.umin.ac.jp, UMIN000005396

Keywords: macula/fovea • laser • clinical (human) or epidemiologic studies: treatment/prevention assessment/controlled clinical trials