Abstract
Abstract: :
Purpose:Central serous chorioretinopathy (CSCR) is a relatively common retinal disease characterized by the developement of a serous detachment of the sensory retina. According to our clinical experience laser photocoagulation leads to a more rapid resorption of subretinal fluid accompanied by faster recovery of visual acuity than in untreated eyes. As well it seems to us that recurrence rate and persistence of metamorphopsia are lower. In this study we investigated the effect of early photocoagulation in CSCR with reference to visual acuity, recurrence rate and persistence of metamorphopsia. Methods: In a retrospective study, 15 consecutive patients with CSCR were treated with photocoagulation within 8 weeks (2 days – 8 weeks) after the onset of symptoms. In all cases, the fluorescein finding was a typical single small focal hyperfluorescent leak from the retinal pigment epithelium which appeared early in fluorescent angiography and increased in size and intensity. There was no obvious diffuse degradation of the retinal pigment epithelium. Treatment covered only the focal leak, treatment parameters were as follows: wavelength 532 nm, spot size 200–400µm, duration 0.1 – 0.2 sec. The patients had a following examination within 4–8 weeks after treatment. Results: 15 patients, 13 men and 2 women, with a mean age at disease onset of 41.9 years were included. After treatment fluorescent angiography revealed no expansile dot in none of the patients. In one patient photocoagulation was applicated twice. In all patients remarkable resorption of subretinal fluid occured. None of the patients suffered further loss of visual acuity, 7 out of 10 patients with serios loss of visual acuity (20/25 or worse) underwent recovery within 4–8 weeks. The mean visual acuity improved by 1.70 lines. All patients reported considerable improvement of symptoms, although mild metamorphopsia persisted in 7 cases. There were no relapses during the follow–up period (mean follow–up time was 6.6 months). Conclusions: This study identified early laser photocoagulation in CSCR as an effective treatment regarding resorption of subretinal fluid and recovery of visual acuity. Patients experienced prompt restoration of vision and disappearance of symptoms. Our ongoing investigations involving a larger number of cases comparing them with a gender–matched and age–controled group of CSCR patients with natural course may reveal the benefit from early laser treatment.
Keywords: retinal detachment • clinical (human) or epidemiologic studies: outcomes/complications • pump/barrier function