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A. R. Dare, D. Lavinsky, F. Magalhães, L. Roisman, F. Tognin, C. E. Moreira, J. A. Cardillo; Focal Juxtafoveal and Grid Pattern Selective Micro-Pulsed Laser Photocoagulation for Treatment of Chronic Central Serous Chorioretinopathy. Invest. Ophthalmol. Vis. Sci. 2009;50(13):214.
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To report the functional and anatomic outcomes of selective 810-nm micro-pulsed laser photocoagulation (SMLP) for chronic idiopathic central serous chorioretinopathy (ICSC) with juxtafoveal leakage.
Ten eyes in 9 patients with persistent ICSC and juxtafoveal leakage longer than 6 months’ duration and leakage pinpoint inside of the foveal avascular zone were treated. Following an individual power adjustment for chorioretinal pigmentation and media transparency, a high density focal and grid (pulse of 2200 µs set at a duty cycle of 10% for 300 milliseconds) was delivered to the pinpoint angiographic leakage a well as to a adjacent area of normal retina. For main outcome measures changes in ETDRS best correct visual acuity and central macular thickness obtained using optical coherence tomography were series-measured over a 6-months follow-up. Pre and post-treatment fluorescein angiography (FA) and microperimetry were assessed.
No visible clinical signs of treatment could be detected either on fundus examination and FA. In parallel, mycroperimetry examination disclosed no induced laser-related focal damage to the treatment area. Improvement of 2 or more lines on the ETDRS chart was achieved in all patients. At the end of follow-up, the average preoperative foveal thickness was reduced by more than half of its original thickness.
The beneficial and selective clinical response even of foveal applied SMLP substantiates a novel and more comprehensive therapeutic strategy for the treatment of ICSC patients, and raises the possibility of improving upon the costly photodynamic therapy if these findings could be validated in sufficiently powered clinical trials.
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