Subthreshold Micropulse Yellow Laser (577 nm) Photocoagulation for Subfoveal Serous Pigment Epithelium Detachment

Abstract

PurposeTo evaluate the efficacy of subthreshold micropulse yellow laser photocoagulation(SMYLP) for subfoveal serous pigment epithelial detachment(SPED).MethodsWe evaluated retrospectively 6 eyes of 5 patients with symptomatic subfoveal SPED treated with SMYLP. SMYLP was performed on the entire area of SPED with Supra 577Y Laser System(Quantel Medical). The SMYLP settings were 100 μm spot diameter, 20 ms duration, 15% duty cycle, 3 × 3 pattern. If SPED was not definitely restored, we applied laser again with more increased power at 1 or 2 months interval.ResultsAll patients were received 3 or 5 times bevacizumab or ranibizumab injections before SMYLP. The total follow‐up period was 26.5 (18–36) months, mean follow‐up period after laser application was 19.8 (15–32) months. Mean height of PED before treatment was 349.2 ± 53.22 μm. About 3 (2–4) sessions SMYLPs were performed. All eyes showed nearly complete resolutions of the PED for 5.6 (5–7) months, which were sustained during the follow‐up. Mean BCVA before treatment was 0.11 (0–0.22) logMAR and mean BCVA at final follow‐up was 0.07 (0–0.22) logMAR. After PED resolution, all patients had increased vision and metamorphopsia improvement. After PED resolution, usually there were seen in mild RPE atrophies in fundus and OCT image, and these atrophies were not aggravated.ConclusionsSMYLP for subfoveal SPED induced the resolution of SPED and symptom improvement. But after SPED resolution, mild RPE atrophy was detected. We think this finding was related to subsequent epithelial atrophy after resolution of SPED or laser damage. Prospectively, the study about long‐term efficacy and safety of this treatment will be needed.