Abstract
The aim of this study was to analyze the efficacy of micropulse laser treatment (MLT) compared with the continuous-wave laser (CL) in treating eyes with chronic central serous chorioretinopathy (CSC) in a 12-month follow-up study. Methods: A retrospective observational study included 51 eyes with chronic CSC; 35 eyes were treated with MLT (Group A), and 16 eyes were treated with CL (Group B). We analyzed the best corrected visual acuity (BCVA) and retinal microstructural changes in spectral optical coherence tomography before the treatment, one and twelve months after the laser procedure. Results: The final mean BCVA was 0.89 ± 0.13 in Group A and 0.71 ± 0.17 in Group B. Photoreceptor length decreased significantly in both groups and amounted 61.2 μm in Group A and 42.9 μm in Group B one year after the treatment. Complete absorption of subretinal fluid twelve months after the laser procedure was noted in 74.3% eyes in Group A and in 87.5% eyes in group B. Hyper-reflective subretinal deposits were observed in 10/35 eyes in Group A but in 15/16 eyes in Group B on the final follow-up visit. Conclusion. MLT-treated patients showed better functional and microstructural results than patients treated with CL.
Highlights
Central serous chorioretinopathy (CSC) is an idiopathic, typically self-limited disease, in which an accumulation of subretinal fluid is observed. e pathophysiology remains unclear; CSC might be assigned to choroidal vessels’ hyperpermeability, impairment of choroidal vascular autoregulation induced by steroids, catecholamines, or sympathomimetic agents, and dysfunction of retinal pigment epithelium (RPE) barrier and pumping [1]
Conventional continuous-wave laser (CL) is still one of the standard therapies to local leakage sites in chronic CSC, and its limitations associated with retinal scaring are, well described
Micropulse laser treatment (MLT) is an alternative nondestructive procedure which may be useful in patients who experience a diffuse leakage or when the leakage is localized within or very close to the foveal avascular zone (FAZ)
Summary
Central serous chorioretinopathy (CSC) is an idiopathic, typically self-limited disease, in which an accumulation of subretinal fluid is observed. e pathophysiology remains unclear; CSC might be assigned to choroidal vessels’ hyperpermeability, impairment of choroidal vascular autoregulation induced by steroids, catecholamines, or sympathomimetic agents, and dysfunction of retinal pigment epithelium (RPE) barrier and pumping [1]. Central serous neuroretinal detachment resolves spontaneously in over 80 to 90% of cases [2]. In ten to twenty percent of the cases, the leakage RPE lingers over several months, leading to structural retinal impairment [3, 4]. Conventional continuous-wave laser (CL) is still one of the standard therapies to local leakage sites in chronic CSC, and its limitations associated with retinal scaring are, well described. Micropulse laser treatment (MLT) is an alternative nondestructive procedure which may be useful in patients who experience a diffuse leakage or when the leakage is localized within or very close to the foveal avascular zone (FAZ). E aim of this study was to analyze and compare the long term functional and anatomical results of 532 nm green laser MLT and CL treatment for chronic CSC
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