scholarly journals Central Serous Chorioretinopathy: Treatment with Laser

2020 ◽  
Vol 13 (11) ◽  
pp. 359
Author(s):  
Maurizio Battaglia Parodi ◽  
Alessandro Arrigo ◽  
Pierluigi Iacono ◽  
Bruno Falcomatà ◽  
Francesco Bandello
Keyword(s):  
Photodynamic Therapy ◽  
Fluorescein Angiography ◽  
Laser Treatment ◽  
Central Serous Chorioretinopathy ◽  
Therapeutic Approaches ◽  
Positive Effects ◽  
The Past ◽  
Laser Treatments ◽  
Subthreshold Laser ◽  
Conventional Laser

Currently, no general consensus exists regarding the management of central serous chorioretinopathy (CSC). Laser treatments include three different therapeutic approaches: conventional laser, subthreshold laser and photodynamic therapy. Conventional focal laser, addressed to seal the leaking points, as evidenced on fluorescein angiography, was largely used in the past, but now, it is almost completely abandoned, owing to the potential complications. Several studies confirmed the positive effects achieved by subthreshold laser treatment in CSC, even though its improper application in the PLACE trial has questioned the effectiveness.

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.

FLUORESCEIN ANGIOGRAPHY-GUIDED PHOTODYNAMIC THERAPY WITH HALF-DOSE VERTEPORFIN FOR CHRONIC CENTRAL SEROUS CHORIORETINOPATHY

Retina ◽  
2010 ◽  
Vol 30 (10) ◽  
pp. 1698-1703 ◽  
Author(s):  
ARIF KOYTAK ◽  
KAZiM EROL ◽  
EROL COSKUN ◽  
NIHAL ASIK ◽  
HAKAN ÖZTÜRK ◽  
...  
Keyword(s):  
Photodynamic Therapy ◽  
Fluorescein Angiography ◽  
Central Serous Chorioretinopathy ◽  
Chronic Central Serous Chorioretinopathy ◽  
Half Dose

Navigated micropulse laser for central serous chorioretinopathy: Efficacy, safety, and predictive factors of treatment response

2021 ◽  
pp. 112067212110640
Author(s):  
Francesca Amoroso ◽  
Alexandre Pedinielli ◽  
Salomon Yves Cohen ◽  
Camille Jung ◽  
Jay Chhablani ◽  
...  
Keyword(s):  
Indocyanine Green ◽  
Fluorescein Angiography ◽  
Treatment Response ◽  
Laser Treatment ◽  
Central Serous Chorioretinopathy ◽  
Indocyanine Green Angiography ◽  
Subretinal Fluid ◽  
Factors Associated ◽  
Micropulse Laser ◽  
Choroidal Hyperpermeability

Purpose There is no widely accepted treatment for persistent/chronic central serous chorioretinopathy. The present study aimed to evaluate the efficacy, safety, and factors associated to treatment response to navigated micropulse laser in chorioretinopathy. Methods Retrospective observational case series including consecutive patients presenting with symptomatic persistent and chronic chorioretinopathy. All patients were treated with 5% navigated micropulse laser with the Navilas system (Navilas®, OD-OS GmBH, Teltwo, Germany), by overlying fluorescein angiography, indocyanine green angiography and/or spectral domain-optical coherence tomography images of visible leaking points and/or choroidal hyperpermeability/subretinal fluid to plan the laser treatment. Results Thirty-nine eyes of 36 consecutive patients (29 men and 7 women, with a mean age of 51.87 years) were included. Logarithm of the minimum angle of resolution (LogMar) best-corrected visual acuity increased from 0.39 ± 0.24 at baseline to 0.24 ± 0.22 at 3 months ( p < 0.0001) and to 0.20 ± 0.07 at 6 months ( p < 0.0001). Subretinal fluid decreased from 166.82 ± 111.11 micron at baseline to 52.33 ± 78.97 micron ( p < 0.0001) at 3 months and 34.12 ± 67.56 micron at 6 months ( p < 0.0001). The presence of a hot spot on fluorescein angiography and a focal choroidal hyperpermeability on indocyanine green angiography, but not the duration of symptoms correlated significantly with the resolution of subretinal fluid at month 3 ( p = 0.023 and p  = 0.001). Conclusion Navigated micropulse laser laser treatment was found to be effective and safe for the treatment of chorioretinopathy, with significant improvement in visual and anatomical outcomes, unaccompanied by any adverse event at 3 and 6 months follow-up. Factors associated to subretinal fluid resolution may allow a better selection of likely responders to navigated micropulse laser treatment.

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