Evaluation of changes in macular structures after subthreshold micropulse laser therapy on chronic central serous chorioretinopathy.

PURPOSE: To evaluate the changes in macular structures following subthreshold micropulse laser (SHML) treatment for chronic central serous chorioretinopathy (cCSC). METHODS: Data of 33 eyes from 31 cCSC patients treated with SHML and followed up for at least 6 months has been included in this retrospective study. Main outcome measurements include resolution of subretinal fluid (SRF) and pigment epithelial detachment (PED), the recovery of ellipsoid zone (EZ) continuity, and the foveal outer nuclear layer (ONL) thickness along with its ratio. RESULTS: Mean observation period is 7.355 months (ranging from 6 to 24 months) and mean number of treatments administered is 1.839 (ranging from 1 to 5). 6 months after SHML treatment, there is a significant decrease in the area of SRF and PED (P < 0.001, P = 0.010, respectively). Additionally, the frequency of continuous EZ and the foveal ONL thickness reveal a significant increase (P<0.001, P = 0.005, respectively). The ratio of foveal ONL thickness is significantly higher after laser treatment, particularly in patients with a disease duration of ≤12 months (p = 0.022, P=0.036, respectively). CONCLUSION: SHML treatment proves to be effective in cCSC eyes, leading to satisfactory recovery of macular structures, especially the photoreceptor layer.

Half-dose photodynamic therapy for chronic central serous chorioretinopathy: Efficacy and safety outcomes in real world.

PURPOSE: To have an insight of the outcomes of half-dose photodynamic therapy (PDT) for patients with chronic central serous chorioretinopathy (CSC) in a real world population. MATERIAL AND METHODS: This is a retrospective consecutive case series, one-centre study, with a 12-month follow-up period. RESULTS: The study took into account 15 eyes of 13 patients. All patients were male in gender and only 1 eye belonged to a non-caucasian. The sample mean age was 51,27±11,66 (between 36 and 74 years); mean baseline best-corrected visual acuity (BCVA) was 0,40±0,25 logMAR and central macular thickness (CMT) was 411,40±88,44µm. All patients had subretinal fluid (SRF) and retinal pigment epithelium (RPE) detachment involving the fovea. In a month time, BCVA and CMT had remarkable improvements with only one eye not gaining letters. At 6-month visit, 46,7% of the eyes were provided with additional treatment (intra-vitreal anti-VEGF or PDT). In the final visit no eye had worsened more than 5 letters and 53,3% had a BCVA improvement of at least 5 letters, with only 2 eyes remaining with RPE detachment and SRF. There was a steady regression in CMT throughout the follow-up; 93,3% had CMT under 300µm and CMT mean was 249,93±72,78µm. There were no reported complications. CONCLUSION: These results support PDT as a valuable approach for therapeutic decisions on chronic CSC as well as the need of other add up treatments for a better final outcome. Further evaluations with longer follow-up's should be taken into consideration for safety issues.

[Morphological and histochemical effects of subthreshold laser therapy on the chorioretinal complex].

A variety of subthreshold laser methods that enable selective and precise treatment of chorioretinal microstructures, thus decreasing the risk of negative changes in retina and choriocapillaries, is used in current ophthalmological practice. This comparative pathomorphological and histochemical study allowed characterizing structural changes and functional activity of chorioretinal cells after application of different subthreshold laser technologies.

Micropulse diode laser photocoagulation for central serous chorio-retinopathy.

PURPOSE: Central serous chorioretinopathy (CSC) is usually characterized by a localized detachment of the neurosensory retina that is self-limiting. However, some cases may persist or recur leading to degenerative changes of the retinal pigment epithelium and the neurosensory retina resulting in severe visual loss and requiring intervention. METHODS: This retrospective case series reports the long-term visual outcome of the use of micropulse laser photocoagulation for this condition with a review of literature. RESULTS: The mean follow up was 17.1 months. Four of the five patients had complete resolution of symptoms whereas one patient had recurrent CSC from a new leak that failed to resolve after repeat micropulse treatment despite improvement in symptoms. DISCUSSION: The outcomes in this case series confirm the long-term efficacy of micropulse laser in the management of CSC. It produces therapeutic effects that appear comparable to those of conventional photocoagulation with no detectable signs of laser-induced iatrogenic damage.