Abstract
Purpose :
Central serous chorioretinopathy (CSC) is characterized by serous detachment of the retina caused by focal leakage through the retinal pigment epithelium (RPE). Because recurrent CSC often leads to retinal atrophy and permanent visual loss we studied the effect of focal laser treatment of the leakage site in patients with acute recurrence of CSC.
Methods :
In a retrospective study a total of 42 eyes were analyzed, that were treated between 2011 and 2015. 84% were male, 16% female. The mean age was 47 years (range 31 to 70 years). We included symtomatic patients suffering from visual deterioration due to recurring CSC with subretinal fluid involving the center of the fovea. Before treatment, each patient underwent a complete ophtalmological examination including the assessment of best corrected visual acuity (BCVA), fundus autofluorescence (FAF), fundus fluorescein angiography (FFA) and optical coherence tomography (OCT). All examinations except FFA were repeated 4-12 weeks after laser treatment. Each patient received direct laser treatment of the leakage site as identified on FFA with mild laser burns. A pulse length of 100ms, a spot size of 100μm and energy of 50-100mW was used with a frequency-doubled neodymium-doped yttrium aluminium garnet (Nd-YAG) laser with 532nm wavelength. Statistical analysis was performed with the paired t-test.
Results :
Mean BCVA improved significantly (p<0.001) from 20/32 (range 20/400 to 20/20) to 20/25 (range 20/32 to 20/16) 8 weeks after treatment. Eight weeks after laser treatment 71% of the patients had an improvement of BCVA and 48% of them showed a BCVA of 20/20. The mean central retinal thickness (CRT) before treatment was 476 μm (SD172 μm) and eight weeks after treatment 238 μm (SD 33 μm), showing a mean reduction of 238 μm (p<0.001). No patient had a deterioration of macular edema or BCVA. Complete resolution of macular edema after treatment was found in 46% after 4 weeks and 65% after 8 weeks. There were no complications from the treatment in any of the eyes.
Conclusions :
Most patients showed rapid and significant improvement of BCVA and resolution of macular edema after laser photocoagulation. Treatment with 532 nm Nd-YAG laser is a safe and effective approach for patients suffering from recurrent CSC with focal leakage. Prospective randomized studies are necessary to compare laser photocoagulation to other treatment options and to assess long-term outcome.
This is an abstract that was submitted for the 2016 ARVO Annual Meeting, held in Seattle, Wash., May 1-5, 2016.