ABSTRACT
AIM: To comparatively analyze the efficacy of subthreshold laser photocoagulation with the NAVILAS&#xAE; Laser system and subthreshold micropulse laser for patients with chronic central serous chorioretinopathy(cCSC).METHODS: A retrospective clinical study. A total of 36 patients(40 eyes)with cCSC were recruited from January 2020 to January 2021 diagnosed at the Affiliated Eye Hospital of Nanjing Medical University. There were 19 patients(23 eyes)treated with subthreshold navigated laser photocoagulation(the Navilas group), and 17 patients(17 eyes)treated with subthreshold micropulse laser(SML)(the SML group). There was no significant difference in baseline data between the two groups(P>0.05). The best corrected visual acuity(BCVA, LogMAR), central macular thickness(CMT), subretinal fluid(SRF)height, vessel densities of the superficial capillary plexus(SCP), the deep capillary plexus(DCP)and area of the foveal avascular zone(FAZ)were collected at 2wk, 1, 3 and 6mo before and after treatment.RESULTS: The BCVA of the two groups were significantly higher than that before treatment at 3 and 6mo after surgery(P<0.05),which was significantly reduced at 2wk after treatment in the Navilas group and was reduced at 1mo after treatment in the SML group(P<0.05). In both groups, there was significant decrease compared with that before treatment at 3 and 6mo after treatment(P<0.05),but there was no significant difference between the two groups(P>0.05). The difference in SRF absorption between the two groups was statistically significant(P<0.05), and the complete absorption rate of SRF in the Navilas group was higher than that in the SML group. SCP, DCP, the area of the FAZ were not significantly different from each time ofbaseline in the two groups(P >0.05).CONCLUSION: Subthreshold laser photocoagulation with the NAVILAS&#xAE; Laser system can rapidly improve the retinal morphology and shorten the course of cCSC to improve the recovery of visual function with its rapid effect, high cost-effectiveness, non-invasiveness and high repeatability, which can be a new clinical method for patients with cCSC.
ABSTRACT
Objective:To observe the safety and effectiveness of targeted navigation laser with continuous wave threshold power in the treatment of chronic central serous chorioretinopathy (CCSC).Methods:A retrospective clinical study. From November 2018 to June 2020, 28 eyes of 28 patients with CCSC diagnosed in the Eye Hospital of Nanjing Medical University were included in the study. Among them, there were 17 males with 17 eyes and 11 females with 11 eyes; all of them had a monocular disease. The average age of the patients was 36.24±5.14 years, and the average course of the diseases was 4.7±1.3 months. All affected eyes underwent best corrected visual acuity (BCVA), fluorescein fundus angiography, fundus autofluorescence, frequency domain optical coherence tomography and angiography, multifocal electroretinogram (mf-ERG) and micro field inspection. BCVA was carried out using the international standard visual acuity chart, which was converted into the logarithmic minimum angle of resolution (logMAR) visual acuity during statistics. A targeted navigation laser system was used for continuous wave power therapy under the threshold. Two weeks and 1, 3 months after treatment, the same equipment and methods as before treatment were used to perform related examinations to observe the BCVA, subfoveal choroidal thickness (SFCT), foveal retinal thickness (CMT), the mean light sensitivity (MS) in the 10° range of the macular center, and the amplitude density of P 1 wave at ring 1 and 2. The t test was used to compare CMT, SFCT, retinal amplitude density and MS before and after treatment. Results:Before treatment and 2 weeks, 1 and 3 months after treatment, the average logMAR BCVA of the eyes were 0.74±0.16, 0.57±0.16, 0.22±0.05, 0.21±0.06, and the average CMT was 512.33±31.56, 350.40±36.61, 256.49±22.38, 253.45±23.65 μm respectively, the average SFCT was 462.82±25.38, 462.37±39.54, 461.51±29.36, 461.25±34.55 μm, the average MS was 16.32±5.41, 17.53±4.23, 19.52±4.12, 21.35±2.77 dB respectively. At different times before and after treatment, BCVA ( t=6.52, 5.71, 6.01; P=0.00, 0.00, 0.00), CMT ( t=3.08, 6.57, 4.90; P=0.01, 0.00, 0.00), SFCT ( t=7.01, 6.54, 4.85; P=0.08, 0.07, 0.17), MS ( t=6.17, 4.25, 5.46; P=0.02, 0.00, 0.00), the difference was statistically significant. The amplitude density of P 1 wave at ring 1 in the affected eye was 64.37±18.25, 85.31±13.98, 98.35±14.52, 98.40±22.17 nV/deg 2, and the amplitude density of P 1 wave at ring2 was 36.12±18.32, 44.02±17.15, 62.35±14.85, 63.17±15.79 nV/deg 2. The amplitude density of P 1 wave at ring 1 ( t=5.11, 9.03, 4.27; P=0.03, 0.00, 0.00) and ring 2 ( t=5.11, 9.03, 4.27; P=0.03, 0.00, 0.00) before and after treatment showed statistical significance. Conclusion:Targeted navigation laser continuous wave threshold power treatment for CCSC can increase the BCVA, macular retinal amplitude density and macular foveal MS, and reduce CMT and SFCT.
ABSTRACT
Diabetic macular edema (DME) is the leading cause of visual impairment in diabetic patients.With developments in laser systems,laser photocoagulation continues to be the necessary treatment for DME.The power development of laser treatment is optimizing efficacy and minimizing complications.This article reviews the laser treatment progress for diabetic macular edema.