Abstract
Purpose :
To compare the treatment outcome of the 577nm subthreshold micropulse laser (SML) and half dose photodynamic therapy (PDT) in patients with chronic central serous chorioretinopathy (cCSC) and persistent subretinal fluid (SRF).
Methods :
This retrospective study included 100 eyes of 100 consecutive patients who were treated with the 577nm SML (Supra Scan, Quantel Medical) (65 eyes) or half dose PDT (62 eyes) for cCSC. 27 eyes received both therapies. If both treatments were performed, the minimal interval between the treatments was 3 months. The treatment was applied at the leakage sites seen in the fluorescein and indocyanine green angiography. The treatment success was evaluated using best corrected visual acuity (BCVA), central retinal thickness (CRT) and resolution of SRF in spectral domain optical coherence tomography (SD-OCT).
Results :
In the SML group 47 eyes (72%) responded to therapy at the last follow-up (6.2± 5.6 months after SML). In 31 eyes (48%) the SRF disappeared completely.
In the PDT group 40 eyes (65%) responded to therapy at the last follow-up (5.8± 5.7 months after PDT). In 9 eyes (15%) the SRF disappeared completely.
The CRT decreased significantly after SML and PDT treatment (mean CRT before SML: 397±143µm, after SML: 278±96µm, p<0.001; mean CRT before PDT: 399±84µm, after PDT: 319±86µm, p<0.001).
BCVA showed no significant increase after treatment (Log MAR before SML: 0.39±0.25, after SML: 0.35±0.3, p=0.052; Log MAR before PDT: 0.37±0.26, after: 0.35±0.3, p=0.343).
At baseline there was no statistically significant difference in CRT between the treatment groups (CRT before SML: 397±143µm, PDT: 399±84µm p=0.184). Six weeks after treatment and at the final follow-up there was a statistically significant lower CRT in the SML group than in the PDT group (CRT 6 weeks after treatment: SML: 294±85µm, PDT: 330±94µm p=0.004; CRT at final visit SML: 278±96µm, PDT: 319±86µm p=0.003).
Conclusions :
Both, the half dose PDT and the 577nm SML are potent treatments for cCSC with persistent SRF. The SML treatment leads to a greater decrease in CRT.
This is an abstract that was submitted for the 2016 ARVO Annual Meeting, held in Seattle, Wash., May 1-5, 2016.