Abstract
Purpose: To investigate the effectiveness and safety of 577-nm subthreshold micropulse laser (SML) on acute central serous chorioretinopathy (CSC).Methods: One hundred and ten patients with acute CSC were randomized to receive SML or 577-nm conventional laser (CL) treatment. Optical coherence tomography and best-corrected visual acuity (BCVA) were performed before and after treatment.Results: At 3 months, the complete resolution of subretinal fluid (SRF) in 577-nm SML group (72.7%) was lower than that in CL group (89.1%) (Unadjusted RR, 0.82; P = 0.029), but it was 85.5 vs. 92.7% at 6 months (unadjusted RR, 0.92; P = 0.221). The mean LogMAR BCVA significantly improved, and the mean central foveal thickness (CFT) significantly decreased in the SML group and CL group (all P < 0.001) at 6 months. But there was no statistical difference between the two groups (all P > 0.05). In the SML group, obvious retinal pigment epithelium (RPE) damage was shown only in 3.64% at 1 month but 92.7% in the CL group (P < 0.001).Conclusions: Although 577-nm SML has a lower complete absorption of SRF compared with 577-nm CL for acute CSC at 3 months, it is similarly effective as 577-nm CL on improving retinal anatomy and function at 6 months. Importantly, 577-nm SML causes less damage to the retina.
Highlights
Central serous chorioretinopathy (CSC) is a common macular condition affected mainly in middle-aged patients
Among 118 eligible patients confirmed as acute CSC with
There was no significant difference between the subthreshold micropulse laser (SML) group and the conventional laser (CL) group in the baseline characteristics in terms of the mean BCVA (LogMAR) (0.32 ± 0.21 vs. 0.39 ± 0.22, P = 0.113) and mean central foveal thickness (CFT) (474 ± 154 vs. 482 ± 157μm, P = 0.780)
Summary
Central serous chorioretinopathy (CSC) is a common macular condition affected mainly in middle-aged patients. It is characterized by a serous neuroepithelium detachment with or without retinal pigment epithelium (RPE) detachment [1]. The acute CSC is considered self-limited and usually resolves spontaneously within 3 to 6 months [2, 3]. Observation is often recommended as the current care for acute CSC [1]. Spontaneous resolution does not always occur, and 30–50% of the patients with CSC experienced recurrence. Even 5% of patients progressed to chronic CSC, resulting in permanent damage in visual acuity [4,5,6]. Based on the above conditions, some proper treatments for acute CSC are reasonable
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