Chronic and Chronic Recurrent Central Serous Chorioretinopathy treatment with Supra 577^TM Yellow - Micropulse Laser

Abstract

Purpose : Chronic central serous chorioretinopathy (CSR) is a retinal condition that has the potential to cause progressive retinal RPE atrophy and permanent visual loss. Identifying effective treatment for chronic CSR is still a challenge. The Supra 577^TM nm yellow micropulse laser (Quantel medical) has been recently used for chronic CSR treatment. Our aim was to test whether this laser improves the central retinal thickness (CRT) and best corrected visual acuity (BCVA) in cases of chronic and chronic recurrent CSR without jeopardizing the integrity of the fovea in a short period of time.

Methods : We performed a retrospective review of the clinical notes of 5 male patients (6 eyes) with chronic and chronic recurrent CSR, that underwent one session of Supra 577^TM nm yellow micropulse laser (Quantel medical) at the Western Eye Hospital, London, in June 2015.
All of the patients underwent laser photocoagulation with the following parameters: laser exposure 20 ms, spot diameter 100 μm, and micropulse mode 5% duty cycle. The patients were followed up every 4 weeks after the treatment was performed. A complete fundus examination, OCT scan and fundus autofluorescence of the retina were performed on every visit. The main outcomes were improvement in CRT and BCVA over the time. Secondary outcomes were any changes of morphology of the retina after the laser.

Results : The mean age of the patients was 50 years old. The average duration of the CSR was 23.4 months (range 6-72 months). Of the total, 50% had a past medical history of chronic use of steroids for a systemic medical condition. All eyes (100%) improved the CRT after a mean of 10 weeks (range 4-16 weeks). The mean CRT improved 60% after the first visit. The CRT was 483 μm pre-treatment and changed to 232 μm post-treatment (p=0.0079). The BCVA improved in 65% of the patients while the other 35% did not showed any change in the visual acuity. The BCVA changed from 0.584 LogMar pre-treatment to 0.528 LogMar post-treatment (P=0.1883). None of the eyes had evidence of retinal damage or changes in the retinal morphology seen in the OCT after the micropulse laser treatment.

Conclusions : The Supra 577^TM yellow micropulse laser appears to have a successful short term outcome and to be safe when treating chronic and chronic recurrent CSR. It improves the CRT even in patients with CSR that had been chronic users of steroids.

This is an abstract that was submitted for the 2016 ARVO Annual Meeting, held in Seattle, Wash., May 1-5, 2016.