Subfoveal Subthreshold Laser Photocoagulation Technique for the Treatment of Central Serous Chorioretinopathy

Abstract

Purpose: : To report the functional and anatomic outcomes of a new therapeutic possibility using a foveal selective 810-nm micro-pulsed laser photocoagulation (SMLP) technique for chronic idiopathic central serous chorioretinopathy (ICSC) with foveal leakage.

Methods: : Six eyes with ICSC with duration longer than 6 months with foveal leakage or diffuse retinal pigment epithelial (RPE) decompensation involving the foveal area were treated. High density focal and macular grid 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. Patients were followed 1, 2, 3, and 6-months after treatment. Pre and post-treatment fluorescein angiography (FA) and microperimetry were assessed.

Results: : No visible clinical signs of treatment could be detected either on fundus examination or FA. Microperimetry examination showed no induced laser-related focal damage to the treated area. Improvement of 3 or more lines on the ETDRS chart was achieved in 4 (67%) of the patients. At the last follow-up visit, average preoperative foveal thickness was reduced by more than half of its original thickness. Only one eye (16,5%) needed to be re-treated.

Conclusions: : This new therapeutic approach enable a selective treatment and an optimized and beneficial clinical response for the treatment of ICSC patients with foveal leakage, with no laser-induced damage.

Keywords: laser • retina • clinical (human) or epidemiologic studies: systems/equipment/techniques