scholarly journals Selective Retina Therapy with Real-Time Feedback-Controlled Dosimetry for Treating Acute Idiopathic Central Serous Chorioretinopathy in Korean Patients

2018 ◽  
Vol 2018 ◽  
pp. 1-9 ◽  
Author(s):  
Ye Ji Kim ◽  
Youn Gon Lee ◽  
Dong Won Lee ◽  
Jae Hui Kim
Keyword(s):  
Real Time ◽  
Central Serous Chorioretinopathy ◽  
Therapeutic Option ◽  
Subretinal Fluid ◽  
Symptom Duration ◽  
Short Term Treatment ◽  
Foveal Thickness ◽  
Clinical Trial Registration ◽  
Korean Patients ◽  
Selective Retina Therapy

Purpose. To evaluate short-term treatment outcomes following selective retina therapy (SRT) with real-time feedback-controlled dosimetry in Korean patients with acute idiopathic central serous chorioretinopathy (CSC). Methods. Sixteen eyes (16 patients) with acute idiopathic CSC (symptom duration < 3 months) were included in this retrospective study. All patients underwent a single session of SRT with real-time feedback-controlled dosimetry. Best-corrected visual acuity (BCVA) and central foveal thickness (CFT) before and 3 months after treatment were examined and compared. Results. The logarithm of minimal angle of resolution BCVA was significantly better 3 months after treatment (0.16 ± 0.18) than at the time of diagnosis (0.27 ± 0.18, P=0.002). Additionally, subretinal fluid had resolved in all 16 eyes 3 months after treatment and CFT was significantly lower 3 months after treatment (215.6 ± 17.9 μm) than at baseline (441.4 ± 124.8 μm, P<0.001). No notable SRT-related complications were observed during the study period. Conclusion. The results of the present study suggest that SRT is a useful therapeutic option for patients with acute idiopathic CSC. Further studies are required to better understand the long-term efficacy of this treatment. This trial is registered with clinical trial registration number NCT03339856.

scholarly journals Mineralocorticoid Receptor Antagonist Treatment for Steroid-Induced Central Serous Chorioretinopathy Patients with Continuous Systemic Steroid Treatment

2018 ◽  
Vol 2018 ◽  
pp. 1-7 ◽  
Author(s):  
Jin Young Kim ◽  
Ju Byung Chae ◽  
Jisoo Kim ◽  
Dong Yoon Kim
Keyword(s):  
Central Serous Chorioretinopathy ◽  
Complete Resolution ◽  
Mineralocorticoid Receptor ◽  
Therapeutic Option ◽  
Subretinal Fluid ◽  
Primary Outcome Measure ◽  
Electrolyte Imbalance ◽  
Systemic Steroid ◽  
Symptom Duration ◽  
Mineralocorticoid Receptor Antagonist

Purpose. To investigate the effectiveness of mineralocorticoid receptor (MR) antagonist in patients with steroid-induced central serous chorioretinopathy (CSC). Methods. A retrospective review was conducted of steroid-induced CSC patients who were treated with the MR antagonist spironolactone 50 mg once per day for at least 1 month. The primary outcome measure was complete resolution rate of subretinal fluid (SRF) after spironolactone treatment. Secondary outcomes included central subfield thickness (CST), subfoveal choroidal thickness (SFCT), and best-corrected visual acuity (BCVA) changes after spironolactone treatment. Results. Seventeen eyes from 15 patients were included in this study. Conditions warranting chronic systemic steroid use were myasthenia gravis (6/15, 40%), glomerulonephritis (5/15, 33.3%), and organ transplantation (4/15, 26.7%). Mean symptom duration of CSC was 4.00 ± 3.04 months. After spironolactone treatment, 14 eyes (82.4%) showed complete resolution of SRF (P<0.001) without discontinuation of systemic steroid. CST and BCVA were significantly improved after spironolactone treatment. SFCT was significantly decreased after spironolactone treatment. No patients experienced electrolyte imbalance after spironolactone treatment. Conclusion. MR antagonist treatment may be a therapeutic option for steroid-induced CSC patients. This treatment modality may be especially beneficial for steroid-induced CSC patients who cannot discontinue steroid medication due to systemic conditions.

scholarly journals The Effect of Selective Retina Therapy with Automatic Real-Time Feedback-Controlled Dosimetry for Chronic Central Serous Chorioretinopathy: A Randomized, Open-Label, Controlled Clinical Trial

2021 ◽  
Vol 10 (19) ◽  
pp. 4295
Author(s):  
Ji-young Lee ◽  
Min-hee Kim ◽  
Seung-hee Jeon ◽  
Seung-hoon Lee ◽  
Young-jung Roh
Keyword(s):  
Real Time ◽  
Central Serous Chorioretinopathy ◽  
Controlled Trial ◽  
Subretinal Fluid ◽  
Post Treatment ◽  
Control Group ◽  
Controlled Clinical Trial ◽  
Chronic Central Serous Chorioretinopathy ◽  
Selective Retina Therapy

This prospective randomized controlled trial evaluated the safety and efficacy of real-time feedback-controlled dosimetry (RFD)-guided selective retina therapy (SRT) in chronic central serous chorioretinopathy (CSC). Forty-four participants with chronic CSC were included and randomly assigned to the control group or SRT group. The SRT laser system with RFD-guidance was applied to cover the entire leakage area. If SRF remained at the 6-week follow-up visit, re-treatment and rescue SRT was performed for the SRT group and crossover group, respectively. The rate of complete resolution of subretinal fluid (SRF), mean SRF height, and mean retinal sensitivity were compared between the two groups at 6-weeks post-treatment. The complete SRF resolution rate in all SRT-treated eyes was evaluated at 12-weeks post-treatment. The rate of complete SRF resolution was significantly higher in the SRT group (63.6%) than in the control group (23.8%) at 6-weeks post-treatment (p = 0.020). The mean SRF height at 6 weeks after SRT was significantly lower in the SRT group (p = 0.041). Overall, SRT-treated eyes showed complete SRF resolution in 70.3% of eyes at 12-weeks post-treatment. RFD-guided SRT was safe and effective to remove SRF in chronic CSC patients during the 3-month follow-up period.

scholarly journals Factors Predicting Response to Selective Retina Therapy in Patients with Chronic Central Serous Chorioretinopathy

2022 ◽  
Vol 11 (2) ◽  
pp. 323
Author(s):  
Minhee Kim ◽  
Seung Hee Jeon ◽  
Ji-young Lee ◽  
Seung-hoon Lee ◽  
Young-jung Roh
Keyword(s):  
Central Serous Chorioretinopathy ◽  
Subretinal Fluid ◽  
Central Macular Thickness ◽  
Fundus Fluorescein Angiography ◽  
Chronic Central Serous Chorioretinopathy ◽  
Safety And Efficacy ◽  
Selective Retina Therapy ◽  
Corrected Visual Acuity ◽  
Anatomical Outcomes ◽  
Best Corrected Visual Acuity

This retrospective study aimed to assess the safety and efficacy of selective retina therapy (SRT) with real-time feedback-controlled dosimetry (RFD) for chronic central serous chorioretinopathy (CSC) and to evaluate factors predictive of treatment response. We included 137 eyes of 135 patients with chronic CSC. SRT was performed to cover each of the leakage areas on fundus fluorescein angiography. Changes in mean best-corrected visual acuity (BCVA), central macular thickness (CMT), and subretinal fluid (SRF) height were evaluated at baseline and at 3 and 6 months after treatment. Complete SRF resolution was observed in 52.6% (72/137 eyes) and 90.5% (124/137 eyes) at 3 and 6 months, respectively. Mean BCVA (logMAR) significantly improved from 0.41 ± 0.31 at baseline to 0.33 ± 0.31 at month 6 (p < 0.001). Mean CMT significantly decreased from 347.67 ± 97.38 μm at baseline to 173.42 ± 30.95 μm at month 6 (p < 0.001). Mean SRF height significantly decreased from 187.85 ± 97.56 µm at baseline to 8.60 ± 31.29 µm after 6 months (p < 0.001). Baseline SRF height was a significant predictive factor for retreatment requirement (p = 0.008). In conclusion, SRT showed favorable anatomical outcomes in patients with chronic CSC. A higher baseline SRF height was a risk factor for retreatment.

scholarly journals Oral Eplerenone Versus Observation in the Management of Acute Central Serous Chorioretinopathy: A Prospective, Randomized Comparative Study

2020 ◽  
Vol 13 (8) ◽  
pp. 170
Author(s):  
Ramesh Venkatesh ◽  
Arpitha Pereira ◽  
Chaitra Jayadev ◽  
Vishma Prabhu ◽  
Aditya Aseem ◽  
...  
Keyword(s):  
Treatment Group ◽  
Central Serous Chorioretinopathy ◽  
Subretinal Fluid ◽  
Control Group ◽  
Symptom Duration ◽  
Imaging Features ◽  
Observation Group ◽  
Fellow Eye ◽  
Beneficial Effects ◽  
Acute Central Serous Chorioretinopathy

In this prospective, interventional case-control study, 58 patients with unilateral acute central serous chorioretinopathy (CSCR) were recruited. Patients ≥ 18 years age, presenting with first episodes of acute CSCR, were included. Acute CSCR was defined by the presence of subretinal fluid (SRF) and symptoms for <12 weeks duration with no clinical or imaging features of chronicity. Patients were alternately divided into treatment (Table Eplerenone 50 mg/day for minimum 1 month) and observation groups. Vision, SRF height and subfoveal choroidal thickness (SFCT) were checked at 1-, 2- and 3-months in both eyes of each group. Each group had 29 eyes. Mean age was 40.4 ± 7.1 and 43.3 ± 8.34 years in treatment and observation group, respectively. Mean symptom duration was 6.46 ± 1.45 and 5.87 ± 2.09 weeks, respectively. Vision improvement to 6/6 was seen in 92%, 100% and 100% cases in treatment group and 74%, 86% and 100% in control group at each visit, respectively. Complete SRF resolution in the treatment group was noted in 45%, 55% and 62% cases at each respective monthly visit. In the observation group, complete SRF resolution was noted in 10%, 21% and 31% at 1-, 2- and 3-month visits, respectively. SRF (p < 0.001) and SFCT (p < 0.001) reduction was noted in the affected eye of both groups. SFCT was reduced in the fellow eye after treatment (p = 0.005) compared to the observation group (p = 0.276). In conclusion, oral eplerenone achieves faster SRF resolution and vision improvement in acute CSCR. Additionally, it shows beneficial effects on the fellow eye.

Optimal fluence rate of photodynamic therapy for chronic central serous chorioretinopathy

2020 ◽  
pp. bjophthalmol-2020-316837
Author(s):  
Dong-Geun Park ◽  
Seongyong Jeong ◽  
Donghyoun Noh ◽  
Min Sagong
Keyword(s):  
Photodynamic Therapy ◽  
Recurrence Rate ◽  
Central Serous Chorioretinopathy ◽  
Subretinal Fluid ◽  
High Rate ◽  
Rank Test ◽  
Retinal Layer ◽  
Fluence Rate ◽  
Foveal Thickness ◽  
Chronic Central Serous Chorioretinopathy

AimsTo investigate the lowest effective fluence rate of photodynamic therapy (PDT) for treating chronic central serous chorioretinopathy (CSC).MethodsFifty-one eyes of 51 patients with chronic CSC were randomly treated with 30% (n=15), 40% (n=16) or 50% (n=17) of the standard-fluence rate of PDT and followed up for 12 months. The success rate, recurrence rate, mean best-corrected visual acuity (BCVA), central foveal thickness (CFT), subfoveal choroidal thickness (SFCT), integrity of the outer retinal layer and complications were evaluated at baseline and at the follow-up periods after PDT.ResultsThe rate of complete subretinal fluid (SRF) resolution in the 30%-fluence, 40%-fluence and 50%-fluence groups was 60.0%, 81.2% and 100.0%, respectively, at 3 months (p=0.009), and 80.0%, 94.0% and 100.0%, respectively, at 12 months (p=0.06). The recurrence rate in the 50%-fluence group was lower than that in the 30%- and 40%-fluence groups at 12 months (30% vs 50%, 40% vs 50%; p=0.002, p=0.030, respectively (log-rank test)). The mean BCVA improved significantly 12 months after PDT only in the 40%- and 50%-fluence groups (p=0.005, p=0.003, respectively). Mean CFT and SFCT decreased significantly at 12 months in the three groups. The rate of complications did not differ significantly among the three groups.ConclusionsA 50%-fluence rate of PDT seems to be the most effective for treating chronic CSC, considering the low recurrence rate and high rate of complete SRF resolution, compared with other low-fluence PDT.Trial registration numberNCT01630863.

scholarly journals Subthreshold laser therapy with a standardized macular treatment pattern in chronic central serous chorioretinopathy

2021 ◽  
Author(s):  
Benedikt Schworm ◽  
Jakob Siedlecki ◽  
Leonie F. Keidel ◽  
Tina R. Herold ◽  
Nikolaus Luft ◽  
...  
Keyword(s):  
Laser Treatment ◽  
Central Serous Chorioretinopathy ◽  
Choroidal Thickness ◽  
Subretinal Fluid ◽  
Symptom Duration ◽  
Macular Function ◽  
Chronic Central Serous Chorioretinopathy ◽  
Subfoveal Choroidal Thickness ◽  
Laser Treatments ◽  
Subthreshold Laser

Abstract Purpose There is an ongoing controversial debate about the effectiveness of laser treatments in chronic central serous chorioretinopathy (cCSC). We performed a prospective non-randomized interventional study to learn about the effects of a subthreshold laser treatment (Topcon Endpoint Management™, Topcon Healthcare Inc., Tokyo, Japan) in patients with cCSC. Methods Patients with cCSC and a minimum symptom duration of 4 months were included and treated with a standardized laser pattern covering the macular area. Retreatment was performed every 3 months if persistent subretinal fluid was observed. The primary endpoint was resolution of subretinal fluid at 6 months. Further outcome parameters included best corrected visual acuity, microperimetry, central macular and subfoveal choroidal thickness. Results A total of 42 eyes of 39 patients were included. Mean patient age was 48 ± 10.6 years (range 25–67). Mean symptomatic time before inclusion into the study was 134 ± 133.4 weeks (16–518). Before inclusion, 78.6% of the patients had failed to resolve subretinal fluid under mineralocorticoid receptor antagonists and 14.3% had a recurrence after half-dose photodynamic therapy. Complete resolution of subretinal fluid was observed in 42.9% at 6 months and in 53.8% at 12 months after baseline. Central retinal thickness decreased from 398 ± 135 µm to 291 ± 68 µm (p < 0.001), subfoveal choroidal thickness changed slightly (430 ± 116 µm to 419 ± 113 µm, p = 0.026), microperimetry-derived macular function improved by 19.1 ± 4.7 dB to 21.3 ± 4.8 dB (p = 0.008) and mean BCVA improved by 4.9 ± 8.6 ETDRS letters (p < 0.001). Conclusion The results show that the investigated laser treatment is effective in reducing subretinal fluid and leads to an improvement of functional parameters.

scholarly journals Clinical Characteristics of Pregnancy-Associated Central Serous Chorioretinopathy in the Chinese Population

2021 ◽  
Vol 2021 ◽  
pp. 1-7
Author(s):  
Jia Yu ◽  
Lei Li ◽  
Chunhui Jiang ◽  
Qing Chang ◽  
Gezhi Xu
Keyword(s):  
Visual Acuity ◽  
Central Serous Chorioretinopathy ◽  
Chinese Population ◽  
Clinical Characteristics ◽  
Subretinal Fluid ◽  
Symptom Duration ◽  
Initial Visit ◽  
Half Dose ◽  
The Mean

Purpose. To investigate the clinical characteristics of pregnancy-associated central serous chorioretinopathy (CSC) in the Chinese population. Methods. The medical records of patients diagnosed with pregnancy-associated CSC from February 2012 to October 2019 were retrospectively reviewed. Best-corrected visual acuity (BCVA), symptom duration, pregnancy-related medical information, and optical coherence tomography (OCT) images were collected. Results. Nine patients (11 eyes) were included. Five women were in their first pregnancy and four were in their second pregnancy, two of whom experienced CSC in their first pregnancy as well. The mean age was 35.00 ± 3.97 years. The mean symptom duration at the initial visit was 19.73 ± 13.65 days. The mean gestational age at the time of development of CSC was 27.11 ± 2.09 weeks. The mean BCVA (logarithm of the minimum angle of resolution (logMAR)) at the initial visit was 0.36 ± 0.18 (Snellen 20/45, range 20/100–20/25). All eyes showed subretinal hyperreflective fibrin on OCT images at the initial visit. Four patients (4 eyes) were lost to follow-up before fluid resolution. The mean BCVA at the final visit was logMAR 0.10 ± 0.15 (Snellen 20/25, range 20/50–20/20)). One eye in the oldest patient had persistent subretinal fluid at 26 months postpartum. The subretinal fluid resolved completely after half-dose photodynamic therapy (PDT); however, the ellipsoid zone at the fovea remained discontinuous at 30 months after half-dose PDT. The remaining six eyes all showed spontaneous resolution of subretinal fluid around delivery and regained intact ellipsoid zone. Conclusions. Pregnancy-associated CSC in Chinese developed mostly in the third trimester and usually recovered spontaneously around delivery with good final visual acuity. However, patients might require long-term follow-up until complete resolution of subretinal fluid and to detect recurrences. Half-dose PDT can be administered early if there is little reduction in the amount of subretinal fluid after delivery.

scholarly journals Factors Affecting Resolution of Subretinal Fluid After Selective Retina Therapy for Central Serous Chorioretinopathy

2021 ◽  
Author(s):  
Manabu Yamamoto ◽  
Akika Kyo ◽  
Kumiko Hirayama ◽  
Takeya Kohno ◽  
Dirk Theisen-Kunde ◽  
...  
Keyword(s):  
Confidence Interval ◽  
Odds Ratio ◽  
Central Serous Chorioretinopathy ◽  
Subretinal Fluid ◽  
Rate Of Change ◽  
Factors Affecting ◽  
Selective Retina Therapy ◽  
Significant Difference ◽  
The Mean

Abstract The purpose of this study was to investigate the factors of clinical outcome of selective retina therapy (SRT) for central serous chorioretinopathy (CSC). This retrospective study included 77 eyes of 77 patients, who were treated with SRT for CSC and observed at least 6 months after the treatment. SRT laser (527 nm, 1.7 µs, 100 Hz) was used for treatment. The mean best-corrected visual acuity (BCVA) (logMAR), central macular thickness (CMT) and central choroidal thickness were changed from baseline to at 6-months follow-up with significant difference. The multivariate analyses found that the rate of change (reduction) in CMT was associated with focal leakage type on fluorescein angiography (FA) (p = 0.03, coefficient 15.26, 95% confidence interval 1.72 – 28.79) and larger baseline CMT (p < 0.01, coefficient -0.13, 95% confidence interval -0.13 – -0.05). Complete resolution of subretinal fluid was associated with nonsmoking history (p = 0.03, odds ratio 0.276, 95% confidence interval 0.086 – 0.887) and focal leakage type on FA (p < 0.01, odds ratio 0.136, 95% confidence interval 0.042 – 0.437). This result may be useful for predicting the therapeutic effectiveness of SRT.

scholarly journals The effect of selective retina therapy for bevacizumab-resistant chronic central serous chorioretinopathy

2021 ◽  
Author(s):  
Seung Hee Jeon ◽  
Minhee Kim ◽  
Jiyoung Lee ◽  
Young-Jung Roh
Keyword(s):  
Central Serous Chorioretinopathy ◽  
Retrospective Cohort ◽  
Subretinal Fluid ◽  
Treatment Results ◽  
Fundus Fluorescein Angiography ◽  
Chronic Central Serous Chorioretinopathy ◽  
Selective Retina Therapy ◽  
Corrected Visual Acuity ◽  
The Mean ◽  
Anatomical Outcomes

Purpose: To evaluate the efficacy of selective retina therapy (SRT), used in conjunction with real-time feedback dosimetry (RFD), in the treatment of bevacizumab-resistant chronic central serous chorioretinopathy (CSC). Patients and Methods: In this retrospective cohort study, 22 eyes of 22 patients with anti-VEGF-resistant chronic CSC, showing focal or diffuse foveal leakages on fundus fluorescein angiography (FFA), were included. After evaluation of the test spots at temporal arcades, SRT (wavelength, 527 nm; pulse repetition rate, 100 Hz; ramping over maximal 15 micropulses; and spot diameter, 200 µm) using RFD was applied to the leakage sites observed on FFA. Changes in the mean best-corrected visual acuity (BCVA), central macular thickness (CMT), and subretinal fluid (SRF) height were evaluated at baseline and at 1, 3, 6, 9, and 12 months following treatment. Results: SRF completely resolved in 81.8% (18/22 eyes) cases at 12-months post-treatment. The mean BCVA (logMAR) improved from 0.49 ± 0.29 at baseline to 0.43 ± 0.36 at 12 months (p = 0.067). The mean BCVA gain was 0.06 logMAR, equivalent to 3 ETDRS letters. The CMT significantly decreased from 323 ± 85.6 µm at baseline to 221.5 ± 60.4 µm at 12 months (p < 0.001). The mean SRF height also significantly decreased from 174.6 ± 86.4 µm at baseline to 35.1 ± 75.4 µm at 12 months (p < 0.001). Conclusion: SRT showed favorable visual and anatomical outcomes in patients with bevacizumab-resistant chronic CSC.

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