Abstract
Purpose :
Central serous chorioretinopathy (CSCR) is a disorder characterized by hyperpermeability of choroid and accumulation of serous fluid between retinal pigment epithelial (RPE) and outer photoreceptors, with RPE focal defects and detachments. It is mostly a self-limiting disease but sometimes results in chronic accumulation of fluid and consequent visual dysfunction.
Several treatment modalities are available including focal Argon photocoagulation, micropulse therapy, endpoint management with thermal laser, and reduced fluence photodynamic therapy (PDT). The purpose of our study was to see the effect of endpoint management (EPM) with thermal laser on the resolution of subretinal in CSCR. We chose this modality because it is efficient in stimulating RPE to pump fluid out of the retina and safe because it does not damage RPE as evident on retinal imaging.
Methods :
Seventeen patients diagnosed with CSCR on clinical exam and multimodal imaging- Fluorescein angiography (FA), fundus autofluorescence (FAF), and optical coherence tomography (OCT), with center involving subretinal fluid (SRF), were selected. Patients with any other central retinal problems were excluded from the study.
After obtaining informed consent, a light intensity burn was applied outside the vascular arcades then the laser power was titrated to 30%. The affected area was treated. Patients were followed up on post-op week 1, month 1, and month 3 for the clinical exam. OCT testing with Heidelberg Spectralis was done to evaluate treatment results.
Results :
Patients were followed up to see the effect of laser on the resolution of fluid. In the case of partial resolution/recurrent SRF, retreatment was done on month 3.
SRF resolved in 52.9%, improved in 23.5%, and remained stable in 23.5% of patients.
Visual Acuity improved in 52.9%, deteriorated in 17.6%, and remained stable in 29.4% of patients.
The absence of RPE scarring or atrophy attributable to laser was confirmed on OCT in all patients.
Conclusions :
Endpoint management is an effective and efficient method of treating center involving CSR with vision loss. It speeds up sub-retinal fluid absorption and improves visual rehabilitation without damaging retinal pigment epithelium.
This is a 2021 ARVO Annual Meeting abstract.