Abstract
Purpose :
Chronic central serous chorioretinopathy (CSR) is a disease characterized by focal fluid accumulation underneath the neuroretina. This can cause irreversible vision loss due to progressive and permanent photoreceptor damage and/or RPE atrophy. The complex and multifactorial pathogenesis of CSR, is still uncertain and the effective treatment for CSR is still not fully explored.
Subthreshold laser has been used to treat CSR and has shown some efficacy in CSR patients with subfoveal and extrafoveal leakage sites.
Our research aims to assess the response and safety of subthreshold laser 577-nm (SML) treatment in patients with chronic CSR.
Methods :
- We performed a retrospective study of 11 eyes of 11 patients diagnosed with chronic CSR treated with one or two sessions of sub-threshold yellow laser.
- Patients received subthreshold micropulse yellow laser photocoagulation at 5% duty cycle at a reduced energy level from the micropulse laser test burns with Laser exposure time of 20 ms, and the spot diameter was 100 microns.
- Inclusion criteria:
> CSR suffered for a minimum of 6 months
> No previous treatment
> No loss of vision
> Presence of subretinal fluid secondary to chronic CSR when the treatment was performed
- Data collected: age, gender, laterality, duration of the CSR, best-corrected visual acuity (BCVA) pre and post-treatment, central retinal thickness (CRT) pre and post-treatment, retina changes post-treatment.
- Cirrus HD-OCT scan, fundus autofluorescence, and fundus colour photos were used to collect clinical findings.
Results :
- Two third of the patients responded to treatment
- The mean CRT measured by OCT pre- treatment changed from 355 +/- 84 μm to 294+/-67 μm post-treatment (P=0.056), showing an 18% average reduction in fluid height
- There was no evidence of retinal pigment epithelium or retinal damage on SD-OCT, FFA, or fundus autofluorescence
- The BCVA changed from 0.57 +/-0.27 LogMAR pre-treatment to 0.46 +/- 0.31 (P=0.11)
Conclusions :
- Subthreshold laser photocoagulation is an effective treatment option for chronic CSCR
- There was no evidence of retinal damage after treatment
- The BCVA didn’t improve much, probably because of the chronic nature of the disease in our patients
- We may try this treatment with acute CSCR, in such cases we expect better results
- Future research with larger samples is required
This abstract was presented at the 2022 ARVO Annual Meeting, held in Denver, CO, May 1-4, 2022, and virtually.