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Nina-Antonia Striebe, Mohammed Khattab, Christian van Oterendorp, Josep Callizo, Hans Hoerauf, Nicolas Feltgen; Is micropulse diode laser photocoagulation effective in treating recalcitrant chronic central serous chorioretinopathy?. Invest. Ophthalmol. Vis. Sci. 2016;57(12):5346. doi: https://doi.org/.
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© ARVO (1962-2015); The Authors (2016-present)
There is no standard recommendation for treating chronic central serous chorioretinopathy (CSC). In recent years Micropulse laser (MPL) was introduced as a new treatment modality. The purpose of this study was to analyze the clinical data of chronic CCS patients treated with MPL, starting from september 2013, when the Micropulse laser treatment was introduced in our clinic.
Retrospective monocentric functional and morphological evaluation of MPL-treatment in a consecutive case series of 17 eyes of 17 patients presenting with chronic CSC - defined as disease duration > 6 months. Prior unsuccessful treatments included acetazolamide (125 mg twice a day) (n=17) and eplerenone (50 mg daily) (n=17) and intravitreal injection of bevacizumab (n=4). Mean follow-up before MPL treatment was 694 days (range 42-5851 days) and after MPL 246 days (range 41-434 days) respectively. Foveal thickness was measured with spectral domain OCT.
Mean foveal thickness during pre MPL standard treatment period was 327 µm (range 180-815 µm) and decreased to 267 µm (range 154-572 µm) during post MPL treatment period (mean value of all follow-up timepoints). For the follow-up examinations within the first 6 months the foveal thickness reduced to 253 µm (range 165-418 µm). The difference between the 6 month post MPL and the pre MPL foveal thickness was statistically significant (p=0,035).Mean best-corrected visual acuity (BCVA) was at first presentation 0.33 (logMAR), 0.37 (logMAR) prior to MPL and 0.32 (logMAR) at the end of the follow up.Six weeks after MPL mean BCVA improved by five to 25 letters in 3 patients, was unchanged in 11 patients and decreased by five letters in 3 patients. At the end of the follow up mean BCVA improved by five to 25 letters in 5 patients, was unchanged in 8 patients and decreased by five letters in 4 patients. No adverse events were observed.
Micropulse laser achieved an anatomical improvement within the first 6 months after treatment in chronic CSC unresponsive to other treatment modalities. Functional results were highly variable and not corresponding to the anatomical improvement. A limitation of the study is the small patient number.
This is an abstract that was submitted for the 2016 ARVO Annual Meeting, held in Seattle, Wash., May 1-5, 2016.
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