Focal double-frequency yttrium-aluminum-garnet laser in central serous chorioretinopathy resistant to intravitreal bevacizumab

Abstract

Purpose: The purpose of this study was to evaluate the effect of focal double-frequency yttrium-aluminum-garnet (YAG) laser therapy in patients with central serous chorioretinopathy (CSCR) resistant to intravitreal bevacizumab (IVB) injections. Methods: This is a retrospective analysis of 16 eyes of 16 patients with CSCR of >3 months duration who had been previously treated with multiple injections of bevacizumab (average 2.7) with no improvement in best-corrected visual acuity (BCVA). All patients had been treated using multiple spots of focal double-frequency YAG laser over areas of focal and diffuse leak. Spectral domain-optical coherence tomography (SD-OCT) was done a day before laser treatment and at 1, 3, and 6 months after. Fluorescein angiography was done for all patients to locate leakage site before laser treatment. Reduction in subretinal fluid height on SD-OCT was used to measure the response to treatment. Results: Mean age of patients was 37.6 ± 3.9 years. The baseline BCVA was improved significantly (P < 0.001) from 0.39 ± 0.45 logarithm of the minimum angle of resolution (log MAR) to 0.11 ± 0.43, 0.10 ± 0.44, and 0.09 ± 0.45 (log MAR) at 1, 3, and 6 months posttreatment, respectively. The baseline OCT mean central macular thickness decreased significantly (P < 0.001) from 554 ± 45 μm to 285 ± 38 μm, 279 ± 34 μm, 275 ± 33 μm at 1, 3, and 6 months posttreatment, respectively. Conclusion: Focal double-frequency YAG laser therapy improved the BCVA and reduced neurosensory detachment in patients with CSCR resistant to IVB injections.