Micropulse Laser Research Articles

Comparing Half-Dose Photodynamic Therapy with Subthreshold Micropulse Laser for the Treatment of Central Serous Chorioretinopathy

To compare the anatomic and functional outcomes of half-dose photodynamic therapy (PDT) and yellow 577-nm subthreshold micropulse laser (SMLT) in treating patients with chronic central serous chorioretinopathy (CSCR). Prospective, double-masked, randomized, controlled clinical trial. Patients with chronic CSCR confirmed by clinical features and multimodal imaging. Eligible patients were randomized (1:1) to receive half-dose PDT or SMLT. The same treatment was repeated if persistent subretinal fluid (SRF) was observed. Treatment responses were evaluated 1 month after treatment and every 3 months until the end point at 12 months. The primary outcome measure was the complete resolution of SRF on OCT scan at month 12. Secondary outcomes included the changes in best-corrected visual acuity (BCVA), central macular thickness (CMT) as measured by OCT, retinal sensitivity as measured by microperimetry, and vision-related quality of life using the National Eye Institute 25-Item Visual Function Questionnaire. Between April 2017 and October 2020, 68 patients were recruited. At 1 month after treatment, SRF resolved in 8 (24.2%) of 33 patients receiving SMLT and in 20 (58.8%) of 34 patients receiving half-dose PDT. This increased to 23 (82.1%) of 28 patients in the SMLT group and 30 (90.9%) of 33 patients in the half-dose PDT group at 12 months of follow-up. Kaplan-Meier survival curves showed significantly faster resolution of SRF in the half-dose PDT group than the SMLT group (P= 0.016). Both groups showed significant improvement in BCVA (-0.12 ± 0.21, P= 0.005 for SMLT;-0.13 ± 0.12, P < 0.001 for half-dose PDT), CMT (-154.2 ± 105.6, P < 0.001 for SMLT;-140.8 ± 94.0, P < 0.001 for half-dose PDT), and retinal sensitivity (5.70 ± 5.02, P < 0.001 for SMLT; 6.05 ± 3.83, P < 0.001 for half-dose PDT) at 12 months compared with baseline. There was no significant difference between the 2 treatment groups at each time point in all investigations except BCVA at 3 months (P= 0.03). When comparing half-dose PDT to subthreshold SMLT, this study has shown both treatments to be viable options, with half-dose PDT achieving faster anatomic success and functional improvement. Proprietary or commercial disclosure may be found in the Footnotes and Disclosures at the end of this article.

Subthreshold micropulse laser light in diabetic macular edema (literature review)

The authors present a review on analyzing techniques for the treatment of diabetic macular edema. Subthreshold micro-pulse laser light is an effective and safe technique for managing diabetic macular edema which can be prescribed repeatedly. The effectiveness of subthreshold micro-pulse laser light is increased in combination with pharmacological therapy which includes inhibitors of the vascular endothelial growth (VEGF) factor.

Atmospheric Thermodynamic Profiling through the Use of a Micro-Pulse Raman Lidar System: Introducing the Compact Raman Lidar MARCO.

It was for a long time believed that lidar systems based on the use of high-repetition micro-pulse lasers could be effectively used to only stimulate atmospheric elastic backscatter echoes, and thus were only exploited in elastic backscatter lidar systems. Their application to stimulate rotational and roto-vibrational Raman echoes, and consequently, their exploitation in atmospheric thermodynamic profiling, was considered not feasible based on the technical specifications possessed by these laser sources until a few years ago. However, recent technological advances in the design and development of micro-pulse lasers, presently achieving high UV average powers (1-5 W) and small divergences (0.3-0.5 mrad), in combination with the use of large aperture telescopes (0.3-0.4 m diameter primary mirrors), allow one to presently develop micro-pulse laser-based Raman lidars capable of measuring the vertical profiles of atmospheric thermodynamic parameters, namely water vapor and temperature, both in the daytime and night-time. This paper is aimed at demonstrating the feasibility of these measurements and at illustrating and discussing the high achievable performance level, with a specific focus on water vapor profile measurements. The technical solutions identified in the design of the lidar system and their technological implementation within the experimental setup of the lidar prototype are also carefully illustrated and discussed.

Subthreshold micropulse laser versus standard laser for the treatment of central-involving diabetic macular oedema with central retinal thickness of

ObjectivesTo estimate the economic costs, health-related quality-of-life outcomes and cost-effectiveness of subthreshold micropulse laser (SML) versus standard laser (SL) for the treatment of diabetic macular oedema (DMO) with central retinal...

X-linked juvenile retinoschisis associated with an RS1 in-frame deletion and bilateral central serous chorioretinopathy.

To report the case of a patient with X-linked juvenile retinoschisis (XLRS), caused by an in-frame deletion of the RS1 gene, who presented visual loss due to bilateral central serous chorioretinopathy (CSC).Methods: Observational case report. A 34-year-old man, with type-A personality, presented with a one-month history of decreased visual acuity and metamorphopsia in his right eye. Funduscopic examination showed a dome-like foveal elevation in both eyes (OU), as well as subtle pigmentary changes of the retinal pigment epithelium with a tapetal reflex in the fovea. Spectral-domain optical coherence tomography revealed intraretinal cystic foveal changes and serous retinal detachment in OU. Fundus fluorescein angiography of OU showed a focal area of intense hyperfluorescence with leakage in late phases. Electroretinogram revealed a markedly attenuated b-wave and a diminished a-wave in photopic and scotopic phases. Genetic testing revealed a hemizygous c.282_284delCTT deletion in the RS1 gene, predicting a p.Ser95del change at the protein level. The patient was diagnosed with XLRS and central serous chorioretinopathy as a coexisting condition. Patient was observed during a 3-month period but showed no improvement. Therefore, subthreshold micropulse laser was applied, achieving complete resolution of signs and symptoms of CSC. CSC can be a cause of acute or subacute visual loss in patients with XLRS when other complications such as vitreous hemorrhage and retinal detachment have been excluded.

Efficacy of subthreshold micropulse laser photocoagulation therapy versus anti-vascular endothelial growth factor therapy for refractory macular edema secondary to non-ischemic branch retinal vein occlusion.

To assess the efficacy of subthreshold micropulse laser photocoagulation (SMLP) therapy versus anti-vascular endothelial growth factor (anti-VEGF) therapy in patients with refractory macular edema (ME) secondary to non-ischemic branch retinal vein occlusion (BRVO). This single-center, prospective, nonrandomized, case-control trial involved patients with refractory ME that responded poorly to three or more initial anti-VEGF injections. The patients were examined and divided into two groups according to their chosen treatment: the intravitreal ranibizumab (IVR) group and the SMLP group. Both groups were followed up monthly for 12 months. Therapeutic efficacy and safety were assessed throughout the follow-up period. The IVR group comprised 49 eyes, and the SMLP group comprised 45 eyes. The improvements in the optical coherence tomography findings and visual acuity were comparable between the two groups at the final follow-up. The total number of injections was significantly lower in the SMLP than IVR group. No serious adverse events occurred during the study period. SMLP therapy is better for patients with central macular thickness (CMT) of ≤400 μm. For patients with CMT of >400 μm, we advise continuation of anti-VEGF agents to reduce ME followed by application of SMLP therapy when CMT has decreased to ≤400 μm.

Micropulse Laser Therapy as an Integral Part of Eye Disease Management.

Ocular diseases can significantly impact vision and quality of life through pathophysiological alterations to the structure of the eye. The management of these conditions often involves a combination of pharmaceutical interventions, surgical procedures, and laser therapy. Laser technology has revolutionized many medical fields, including ophthalmology, offering precise and targeted treatment options that solve some of the unmet needs of other therapeutic strategies. Conventional laser techniques, while effective, can generate excessive thermal energy, leading to collateral tissue damage and potential side effects. Compared to conventional laser techniques, micropulse laser therapy delivers laser energy in a pulsed manner, minimizing collateral damage while effectively treating target tissues. The present paper highlights the advantages of micropulse laser therapy over conventional laser treatments, presents the implications of applying these strategies to some of the most prevalent ocular diseases, and highlights several types and mechanisms of micropulse lasers. Although micropulse laser therapy shows great potential in the management of ocular diseases, further research is needed to optimize treatment protocols, evaluate long-term efficacy, and explore its role in combination therapies.

Intravitreal injections with anti-VEGF agent aflibercept versus subthreshold micropulse laser for chronic central serous chorioretinopathy: the alternative treatment regimens for verteporfin-shortage in China

Purpose To compare short-term anatomical outcomes observed in optical coherence tomography (OCT) between intravitreal injection (IVI) with anti-vascular endothelial growth factor (VEGF) agent aflibercept (IVA) and subthreshold micropulse laser (SML) therapy in chronic central serous chorioretinopathy (cCSC). Methods Thirty-nine eyes of 36 patients with symptomatic cCSC in this retrospective study received either IVA or SML between December 2020 and August 2022. Spectral-domain-OCT (SD-OCT) findings were compared between the two treatment groups in terms of central macular thickness (CMT), serous subretinal fluid (SRF) height, the presence of pigment epithelial detachment (PED) and subretinal hyperreflective foci (HF) at baseline and one-month follow-up visits. Results Both groups showed significant reductions in CMT and SRF at one-month follow-up visit. However, there were no statistically significant differences between the IVA and SML groups. Complete SRF resolution was observed in 10 out of 21 and 7 out of 18 eyes in the IVA and SML groups, respectively; however, retinal pigment epithelial (RPE) damage remained persistent in patients with PEDs at baseline. Conclusions Both IVA and SML were effective in treating cCSC. IVA and SML treatments had comparable effects in reducing CMT and SRF in eyes with cCSC. Further prospective studies with larger sample sizes and long-term follow-up visits are warranted to identify the long-term efficacy.

Efficacy and safety of subthreshold micropulse laser in the treatment of acute central serous chorioretinopathy.

To analyze the efficacy and safety of subthreshold micropulse laser (SML) in the treatment of acute central serous chorioretinopathy (CSC). This is a retrospective case analysis study. Totally 58 eyes of 58 patients were enrolled, and they were divided into different groups. And 39 patients were treated with SML (SML group) and 19 patients were only observed (observation group). The follow-up period was 3mo after diagnosis. The best corrected visual acuity (BCVA), central retinal thickness (CRT), superficial retinal vascular density (SRVD), deep retinal vascular density (DRVD), the superficial and deep foveal avascular zone (FAZ) area, retinal light sensitivity (RLS), perfusion area of choroidal capillary layer (CCL), subfoveal choroidal thickness (SFCT) and fundus autofluorescence (FAF) were investigated. The BCVA, CRT, SRVD, DRVD, the superficial and deep FAZ area, RLS, SFCT of SML group were significantly improved at 3mo (all P<0.05). In the observation group, only CRT, DRVD and SFCT were improved (all P<0.05). Other research items in the observation group were not significantly different from baseline (all P>0.05). At the last follow-up, the BCVA and RLS in the SML group were better than those in the observation group, and CRT was lower, SRVD and DRVD, perfusion area of CCL were larger (all P<0.05). On FAF, no change of treatment spots was found after treatment. No structural laser damage was observed on optical coherence tomography (OCT) and optical coherence tomography angiography (OCTA), and no choroidal neovascularization was observed. SML treatment of acute CSC can improve BCVA, RLS, and perfusion area of CCL, reduce CRT, increase SRVD and DRVD, and is safe.

A versatile laser-induced porcine model of outer retinal and choroidal degeneration for preclinical testing.

Over 30 million people worldwide suffer from untreatable vision loss and blindness associated with childhood-onset and age-related eye diseases caused by photoreceptor (PR), retinal pigment epithelium (RPE), and choriocapillaris (CC) degeneration. Recent work suggests that RPE-based cell therapy may slow down vision loss in late stages of age-related macular degeneration (AMD), a polygenic disease induced by RPE atrophy. However, accelerated development of effective cell therapies is hampered by the lack of large-animal models that allow testing safety and efficacy of clinical doses covering the human macula (20 mm2). We developed a versatile pig model to mimic different types and stages of retinal degeneration. Using an adjustable power micropulse laser, we generated varying degrees of RPE, PR, and CC damage and confirmed the damage by longitudinal analysis of clinically relevant outcomes, including analyses by adaptive optics and optical coherence tomography/angiography, along with automated image analysis. By imparting a tunable yet targeted damage to the porcine CC and visual streak - with a structure similar to the human macula - this model is optimal for testing cell and gene therapies for outer retinal diseases including AMD, retinitis pigmentosa, Stargardt, and choroideremia. The amenability of this model to clinically relevant imaging outcomes will facilitate faster translation to patients.

Микроимпульсная лазерная трабекулопластика как метод лечения первичной открытоугольной глаукомы

Purpose. Analysis of the results of treatment of primary open-angle glaucoma by the method of microimpulse laser trabeculoplasty with a power of 1000 mW and different operating cycles. Material and methods. 33 patients (36 eyes) who underwent microimpulse laser trabeculoplasty were included in the study: in the 1st month, MLT with a power of 1000 mW and a duty cycle of 15% was performed in 19 patients (21 eyes), in the 2nd month MLT s rabochim cyclom 10% 14 patients (15 glasses). Criterion of inclusion of development of patients with primary open glaucoma and pigmented angular anterior camera. Observation and measurement of VGD is carried out an hour after the laser procedure, after 10 days, and after 1; 3, 6 months. Results. In the MLT group with 15% duty cycle, at 6-month follow-up, we noted a decrease in IOP by more than 20% of baseline or more than 3 mmHg, in 78% of cases, however, in the MLT group with a 10% duty cycle, this figure was only 33%. Also, in the MLT group with 15% workers, there was a decrease in the number of antihypertensive drugs used by 32%, while in the MLT group with a 10% work cycle, this figure was 9%. Conclusions. Treatment with micropulse laser trabeculoplasty for primary open-angle glaucoma is a new method that affects pigmented cells without thermal damage. However, to achieve a hypotensive effect, the laser power should be 1000 mW, and the duty cycle is 15%, since with a duty cycle of 10%, no hypotensive effect is observed in the long-term observation period. Keywords: glaucoma, laser trabeculoplasty, pigmented anterior chamber angle

Эффективность субпорогового микроимпульсного лазерного воздействия при посттромботической ретинопатии

Purposeof the study. Evaluation of the effectiveness of the combined treatment of post-thrombotic retinopathy (PTR) with the inclusion of the method of subthreshold micropulse laser exposure using a 577 nm yellow diode laser. Material and methods. 28 patients (39 eyes) with PTR were under observation. The patients were divided into 2 groups: in group 1 (n = 14, 20 eyes), patients received combined treatment with antiVEGF therapy and subthreshold micropulse laser exposure; in group 2 (n = 14, 19 eyes), patients were treated only with antiVEGF therapy. Results. As a result of the treatment, a significant increase in the average value of maximally corrected visual acuity was recorded in both groups. According to OCT data, a significant decrease in the height of macular edema was determined. At the same time, the average retinal thickness in the central zone in group 1 was significantly lower than in group 2. Conclusion. Combined treatment that combines antiVEGF therapy and subthreshold micropulse laser exposure is a fairly effective and safe method in cases of macular edema in post-thrombotic retinopathy. Keywords: post-thrombotic retinopathy, macular edema, subthreshold micropulse laser exposure

Functional Outcomes and Safety Profile of Trans-Foveal Subthreshold Micropulse Laser in Persistent Central Serous Chorioretinopathy.

Our study evaluated visual function changes after subthreshold micropulse laser (SML) treatment in persistent central serous chorioretinopathy (CSC) and SML safety profile. We conducted a prospective study including 31 fovea-involving CSC patients. The natural course was observed for the first 3 months, SML was performed at 3 months, and SML effectiveness was observed at 6 months. At all three clinical visits, optical coherence tomography (OCT), best corrected visual acuity (BCVA), contrast sensitivity (CS) in five spatial frequencies (1.5, 3.0, 6.0, 12.0, and 18.0 cycles per degree (cpd)), microperimetry (MP), and multifocal electroretinography (mfERG) were performed. The SML safety profile was evaluated with functional and morphological parameters. In the cohort of all CSC patients treated with SML, the statistically significant average improvement was observed in BCVA (p = 0.007), CS-1.5 (p = 0.020), CS-3.0 (p = 0.050), CS-12.0 (p < 0.001), CS-18.0 (p = 0.002), CS (CS-A) (p < 0.001), MP in the central ring (MP-C) (p = 0.020), peripheral ring (MP-P) (p = 0.042), and average retinal sensitivity (MP-A) (p = 0.010). After the SML treatment, mean changes in mfERG amplitudes and implicit times in our cohort were not statistically significant. No morphological or functional adverse effects of SML treatment were observed. SML treatment in persistent CSC episodes leads to significant functional improvement and has an excellent safety profile.

Comparing functional and vascular layer outcomes of laser photocoagulation versus subthreshold micropulse laser for diabetic m.

To compare the efficacy of conventional laser (CL) and subthreshold micropulse laser (SML) for treating diabetic macular edema in terms of functional outcomes and changes in quantitative metrics for the retinal capillary and choriocapillary vascular layers. Fifty-two eyes from 52 patients with treatment-naïve clinically significant macular edema were randomly assigned to the CL or SML group in a 1:1 ratio. Best-corrected visual acuity, central macular thickness (CMT) and optical coherence tomography angiography (OCT-A) scans were measured at baseline, 1-, 3- and 6-months post-treatment. The SML group showed rapid visual recovery, improving from baseline of 0.320 ± 0.31 logMAR (20/42 Snellen) to 0.270 ± 0.22 logMAR (20/37 Snellen) at 1 month (p = 0.038); and had significant improvements in CMT at 6-month post-treatment (353.88 to 301.00µm, p = 0.005). Statistically significant changes were detected across all OCT-A metrics, including vessel density (VD), vessel length density (VLD), vessel diameter index (VDI) and fractal dimension (FD), at 6 months for both groups in the deep capillary plexus (DCP) and choriocapillary plexus (CCP). SML resulted in early visual recovery and sustained macular thickness improvement in the treatment of DME. Microvascular perfusion parameters, including VD, VLD and FD, improved in the DCP and CCP for both treatment groups at 6-months post-treatment.

Infographic: Half-dose photodynamic therapy versus high-density subthreshold micropulse laser treatment in patients with chronic central serous chorioretinopathy: the PLACE trial.

Infographic: Half-dose photodynamic therapy versus high-density subthreshold micropulse laser treatment in patients with chronic central serous chorioretinopathy: the PLACE trial.

Selective laser trabeculoplasty versus micropulse laser trabeculoplasty for intraocular pressure control in patients with primary open angle glaucoma: a 12-month retrospective comparative study.

This study was designed to compare the efficacy of selective laser trabeculoplasty (SLT) and micropulse laser trabeculoplasty (MLT) in patients with primary open angle glaucoma (POAG) requiring additional IOP control. In this retrospective, comparative study, we reviewed the charts of POAG patients requiring additional IOP lowering, who underwent either SLT or MLT and were followed for at least one year. We evaluated mean intraocular pressure (IOP), mean IOP reduction from baseline and mean number of glaucoma medications 1, 3, 6 and 12months after treatment. Success rates (success defined as IOP ≤ 21mmHg and ≥ 20% reduction from baseline IOP without additional medications, new laser session, or glaucoma surgery) at one year were also compared. A total of 98 POAG patients were included, 52 individuals in the SLT group and 46 in the MLT group. Laser treatment resulted in significant mean IOP reductions from baseline in both groups (SLT = -6.0 ± 3.3mmHg (24.9%) and MLT = -5.8 ± 2.6mmHg (23.4%)) (p < 0.001). However, there was no statistically significant difference between the mean IOP reductions in both groups (p = 0.74). At 12months, the mean number of glaucoma medications was significantly smaller in the SLT group (1.17 + 0.4) when compared to the MLT group (2.21 + 0.2) (p = 0.001). Additionally, after 12months, success was obtained in 32 (61.5%) SLT cases compared to 27 (58.7%) MLT-treated eyes (p = 1.0). MLT and SLT are both effective in controlling the IOP in POAG patients requiring additional IOP reduction. However, after 12months, SLT demonstrated a greater efficacy in reducing medication burden when compared to MLT.Trial registration: CEP/CONEP/MS Brazil 40948620.9.0000.5600.

Micropulse Laser Trabeculoplasty with 577 nm Wavelength at 1500 or 1000 mW for Primary Open-Angle Glaucoma: A Pilot Study.

Aim: To investigate the efficacy and safety of micropulse laser trabeculoplasty (MLT) using a 577 nm yellow wavelength laser randomly assigned to either 1500 or 1000 mW in patients with primary open-angle glaucoma (POAG). Methods: A prospective, double-blinded study of POAG patients was performed in a single center. MLT treatment included a 577 nm micropulse laser (IRIDEX IQ 577TM, IRIDEX, Mountain View, CA, USA) to 360° of the trabecular meshwork at randomly assigned varying powers: 1500 mW in one eye (MLT 1500 group) and 1000 mW in the other (MLT 1000 group). Best-corrected visual acuity (BCVA), intraocular pressure (IOP), corneal central thickness (CCT), and endothelial cell count (ECC) were evaluated at baseline (T0), post-operative 1 h (T1), 24 h (T2), 1 month (T3), 3 months (T4), and 6 months (T5) after laser treatment. Topical medications were assessed pre-treatment and at T4. Results: Among the 18 eyes included, we achieved a success rate (IOP reduced > 20%) in 77% of sampled eyes. In particular, IOP reduced at T2 and T3 with both MLT 1500 and 1000 without any significant differences (IOP reduction 22.9% vs. 17.3%, respectively, MLT1500 vs. MLT1000 at T2). The IOP returned to baseline values at T4 and T5 in both groups, with a reduction in topical medications administered from 2.5 ± 1.1 to 2.0 ± 1.2 to the 1500 mW group and from 2.4 ± 1.0 to 1.9 ± 1.0 to the 1000 mW group. At 1 h post-laser treatment, a transient IOP spike was registered among the MLT1500 group. There were no differences in CCT and ECC at any timepoint according to the laser powers. Conclusions: Over a 6-month follow-up period, 577 nm MLT at either 1500 or 1000 mW reduces IOP, enabling a stable reduction in the number of topical medications required for patients treated for POAG without any significant difference in terms of effectiveness and safety.

Prognosis evaluation with optical coherence tomography in chronic central serous chorioretinopathy

BackgroundCentral serous chorioretinopathy (CSCR) is the fourth most common retinopathy that causes severe vision loss and is frequently seen in young and active patients. Our aim in this study is to evaluate whether a foresight about the prognosis of patients with CSCR can be obtained by optical coherence tomography (OCT) findings. Materials and methodsPatients diagnosed with chronic CSCR at Fatih Sultan Mehmet Research and Training Hospital, Ophthalmology Department, were screened between January 2017 and September 2019, and 30 patients were included in the study. The anatomical and functional changes of the patients during the 6-month follow-up and the relationship between the OCT findings at baseline and the best corrected visual acuity (BCVA) in the sixth month were evaluated. ResultsAll of the participants were treated with subthreshold micropulse laser therapy. BCVA increased significantly at first month and sixth month examinations compared to baseline, while the central macular thicknesses decreased significantly (p = 0.01, p = 0.00). Among the parameters examined in the baseline OCT, a positive correlation was found between the thickness of the outer nuclear layer (r = -0.520, p = 0.003) and BCVA at sixth month. In addition, subretinal fluid density and the number of intra-subretinal hyperreflective dots negatively affected BCVA (r = 0.371, p = 0.044 and r = 0.509, p = 0.004). ConclusionOuter nuclear layer thickness, subretinal fluid density and intra-subretinal hyperreflective dots were the OCT biomarkers related to sixth month BCVA. The clinical use of these biomarkers will help evaluate the prognosis of the CSCR.

Randomized controlled trials in central serous chorioretinopathy: A review.

Central serous chorioretinopathy (CSCR), a common chorioretinal disease, presents with a myriad of manifestations. Acute CSCR presents with localized neurosensory detachment whereas chronic CSCR may show widespread retinal pigment epithelium (RPE) changes, chronic shallow subretinal fluid, andchoroidal neovascularization (CNV) suggestive of a variable natural history leading to suboptimal visual outcomes. Even though multiple treatment options including laser photocoagulation, photodynamic therapy, micropulse laser, anti-vascular endothelial growth factors, and systemic drugs (spironolactone, eplerenone, melatonin, mifepristone) are available, there isan absence of any standardized treatment protocol or gold standard treatment modality. Moreover, their performance compared to observation especially in acute CSCR is still debatable. Compared to other chorioretinal diseases such as age-related macular degeneration, diabetic retinopathy, diabetic macular oedema, and retinal vein occlusion, there is arelative dearth of randomized controlled trials in CSCR. Multiple inconsistencies including reliance on history of disease duration, variable inclusion criteria/disease descriptors/study endpoints, and availability of multiple treatment modalities lead to difficulties in designing RCTs. A consensus-based treatment protocol, therefore, is still elusive. We reviewed the literature and compiled the list of papers published to date, wherein we analyse and compare the inclusion criteria, imaging modalities, study endpoints, studyduration, andstudy results. Correcting these discrepancies and deficiencies will help standardize future study designs, facilitating a next step towarda standardized treatment protocol.

Выбор тактики лечения пациентов с хронической формой центральной серозной хориоретинопатии, осложненной пахихориоидальной неоваскулопатией

Purpose. To identify the initial OCT parameters that allow determining the tactics of treating patients with chronic central serous chorioretinopathy complicated by pachychoroidal neovasculopathy. Material and methods. 73 patients (n = 73) with monolateral chronic form of central serous chorioretinopathy complicated by pachychoroidal neovasculopathy. All patients were given intravitreal angiogenesis inhibitors as initial therapy. Depending on the results of treatment, the patients were divided into groups: control – 39 (n = 39) patients with positive dynamics for the treatment used, the main group – 34 (n = 34) patients with the lack of the desired effect from intravitreal administration of angiogenesis inhibitors, who were treated of combined treatment with the connection of subthreshold micropulse laser exposure. Initial OCT parameters which were different for both groups were being found. Results. In the main group, exacerbation of central serous chorioretinopathy had a greater impact than subactive choroidal neovascularization 1, that determined the positive result of combined treatment. Characteristic for the main group of OCT predictors were the thickness of the choroid more than 470 µm, the area of choroidal neovascularization type 1 less than 0.27 mm², the height of detachment of the neurosensory retina more than 310 µm. The initial OCT parameters, typical for patients in the control group, were the subfoveolar thickness of the choroid less than 470 µm, the area of the choroidal neovascular membrane more than 0.27 mm², and the maximum height of neurosensory retinal detachment less than 310 µm. In patients of this group, the prevailing element of the current clinical condition was the activation of type 1 of pachychoroidal neovascular membrane, which determined the favorable functional results of anti-VEGF therapy. Conclusion. During the study, OCT parameters were identified that make it possible to timely determine the tactics of treating patients with a chronic form of central serous chorioretinopathy complicated by pachychoroidal neovasculopathy. Keywords: chronic central serous chorioretinopathy, pachychoroidal neovasculopathy, optical coherence tomography