Abstract
Background: Central serous chorioretinopathy (CSC) is a common macular condition characterized by detachment of the neuroretina and is a frequent cause of central vision loss in adults. Among the various therapeutic strategies, subthreshold microsecond pulsed laser (SML) treatment has become a useful option. Despite the suggested involvement of choroidal circulatory disturbances in CSC, the effects of this treatment on macular microperfusion have not been fully evaluated yet. Herein, we report the impact of SML on retinal and choroidal microvascular flow using non-invasive optical coherence tomography (OCT) angiography (OCTA). Methods: In this study, CSC patients with persistent subretinal fluid (SRF) with or without secondary choroidal neovascularization (CNV) were included (referred to as the pachychoroid neovasculopathy (PNV) group and the CSC group, respectively). SML was conducted using a yellow (577 nm) laser with a duty cycle of 10%, spot size of 200 µm and duration of 200 ms. Best corrected visual acuity (BCVA) as well as OCT and OCTA images were evaluated at baseline and 4 weeks after SML. OCTA parameters of interest included full retinal perfusion (FRP), choriocapillaris perfusion (CCP), Sattler’s layer perfusion (SLP), and Haller’s layer perfusion (HLP), which were evaluated longitudinally and compared to unaffected fellow eyes. Results: 27 affected eyes and 17 fellow eyes from 27 patients were included. Before treatment, central retinal thickness (CRT) and subfoveal choroidal thickness (SFCT) of affected eyes were significantly larger than in fellow eyes. Four weeks after SML, CRT decreased significantly, whereas perfusion parameters did not change. In subgroup analyses, the CSC group showed a significant decrease in SFCT, whereas the PNV group did not despite the decrease in CRT. Conclusion: Our results suggest that the SML may affect the SFCT of the CSC, but not the PNV patients at least within four weeks following treatment. This effect seems to be independent of the change in choroidal perfusion measured with OCTA.
Highlights
Central serous chorioretinopathy (CSC) is a common chorioretinal disease and a frequent cause of central vision loss, primarily affecting people between 20 to 60 years of age
CSC is an entity of the pachychoroid disease spectrum, in which the choroidal vessels are typically dilated, and leakage might be seen in indocyanine green angiography (ICGA) [2,3]
We included patients who were diagnosed with CSC based on the subretinal fluid (SRF) involving the macula as demonstrated by spectral domain optic coherence tomography (SD-optical coherence tomography (OCT)) and persistent
Summary
Central serous chorioretinopathy (CSC) is a common chorioretinal disease and a frequent cause of central vision loss, primarily affecting people between 20 to 60 years of age It is characterized by serous detachment of the neuroretina, typically with localized 4.0/). CSC is an entity of the pachychoroid disease spectrum, in which the choroidal vessels are typically dilated, and leakage might be seen in indocyanine green angiography (ICGA) [2,3]. This mechanism is suggested to lead to choriocapillaris hypoperfusion, causing localized RPE damage [4]. OCTA parameters of interest included full retinal perfusion (FRP), choriocapillaris perfusion (CCP), Sattler’s layer perfusion (SLP), and Haller’s layer perfusion (HLP), which were evaluated longitudinally and compared to unaffected fellow eyes
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