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Musa Abdelaziz, Michael M Lai; Focal Laser Therapy in Symptomatic Central Serous Chorioretinopathy. Invest. Ophthalmol. Vis. Sci. 2018;59(9):3124.
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© ARVO (1962-2015); The Authors (2016-present)
Central serous chorioretinopathy (CSC) management lacks defined guidelines due the variable natural history of the disease. We performed a retrospective, observational clinical study to assess the efficacy of focal laser therapy on structural and functional outcomes in symptomatic non-resolving or recurrent subfoveal fluid in select cases of CSC.
We reviewed three years of medical charts based on international classification of disease codes 9 and 10 for CSC in conjunction with current procedural terminology (CPT) codes for focal laser therapy, resulting in a total of 28 subjects. After accounting for duplicates, excluding non-CSC cases (idiopathic choroidal neovascularization, peripapillary neovascularization, and polypoidal choroidal neovascularization), and excluding cases previously treated with photodynamic therapy, a total of 14 eyes from 14 subjects remained. The gender, age, visual acuity (VA) on day of laser therapy and at last visit, central foveal thickness (CFT) on day of laser therapy and last visit, duration of follow up and complications/failures of therapy were recorded. VA was converted to log of the minimum angle of resolution (logMAR) for analysis. Statistical analysis was completed using Excel Data Analysis Toolkit.
The average age of subjects included were 51 years of age, with 13 out of 14 subjects being male (93%) and mean follow-up post-laser therapy of 6 months. 10 subjects failed observation prior to treatment with focal laser therapy and 4 had recurrence after spontaneous resolution prior to focal laser therapy. The average initial VA was 20/50 (logMAR 0.39) and average final VA was 20/30 (logMAR 0.18) with an average gain of 2 lines (logMAR -0.21, p = 0.014 and 95% CI -0.35 to -0.07). The average initial CFT was 433 µ and average final CFT was 243 µ with an average improvement of 190 µ (p = 0.001 and 95% CI -293 to -87). Two subjects developedrecurrence of symptomatic CSC requiring further treatment with intravitreal injections and one developed a choroidal neovascular membrane which resolved with intravitreal Avastin. No subjects had loss of visual acuity.
Focal laser therapy resulted in resolution of symptomatic subretinal fluid in select cases of CSC with an improvement in both structural and functional outcomes. Focal laser therapy still has a in the treatment of CSC and a prospective study can further delineate its role in treatment of CSC.
This is an abstract that was submitted for the 2018 ARVO Annual Meeting, held in Honolulu, Hawaii, April 29 - May 3, 2018.
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