Abstract
Purpose :
To analyze the effect of selective retinal therapy (SRT) in patients with chronic central serous chorioretinopathy (cCSC), which was defined as persistent subretinal fluid and symptoms for at least 4 months.
Methods :
This retrospective study included 77 eyes of 70 patients. Subjects showing focal leakage in fluorescein angiography (FA) were treated with the Lutronic R:GEN 527-nm Nd:YLF laser with 15 pulses at 100 Hz repetition rate for 1.7 µs at 200 µm spot size. Best corrected visual acuity (BCVA) in logMAR, clinical examination, FA and optical coherence tomography were analyzed 1, 3, 6, 12 and 24 months after treatment. Re-treatment was performed in patients showing persistent or recurrent fluid.
Results :
SRT was performed in 61 (79%) subjects and 16 patients (21%) who received no SRT served as controls. No significant difference in BCVA and central retinal thickness (cRT) was observed between SRT and control groups at baseline. The SRT group showed a significant increase in BCVA after 3, 6 and 12 (p<0.03). A significant decrease in cRT in the SRT group was observed after 1, 3, 6 and 12 (p<0.003). However, after 24 months 10 patients available for follow-up showed no significant improvement in BCVA and cRT. 60% patients in this group had recurrent fluid and needed re-treatment. The control group showed no significant increase in BCVA at any follow-up examination but a significant decrease in cRT after 3, 6 and 12 (p<0.03) months. Re-treatment was performed in 34 (56%) patients after an average of 7.6±8.6 months. Sub-analysis of the SRT group showed no significant increase in BCVA in patients receiving only one SRT, however a significant decrease in cRT after 1, 3, and 12 months (p<0.05). Patients needing re-treatment showed significant increase in BCVA after 1, 3 and 6 months (p<0.05) from the first SRT and a significant decrease in cRT after 1, 3, 6 and 12 (p<0.02) months. No adverse effects occurred.
Conclusions :
SRT is an effective treatment for cCSC patients presenting with leakage points. The therapeutic efficacy of SRT appears to be limited for a single episode, necessitating re-treatment if there is recurrent fluid. This suggests that SRT is helpful in treating symptoms caused by RPE leaks but may not influence the pathophysiology of the disease itself. SRT is an effective symptomatic therapy approach in cCSC with re-treatment needed due to the chronic course of cCSC.
This abstract was presented at the 2023 ARVO Annual Meeting, held in New Orleans, LA, April 23-27, 2023.