scholarly journals Increase in Central Retinal Edema after Subthreshold Diode Micropulse Laser Treatment of Chronic Central Serous Chorioretinopathy

2015 ◽  
Vol 2015 ◽  
pp. 1-4 ◽  
Author(s):  
Maciej Gawęcki
Keyword(s):  
Central Serous Chorioretinopathy ◽  
Fundus Autofluorescence ◽  
Subretinal Fluid ◽  
Intravitreal Bevacizumab ◽  
Thermal Reaction ◽  
Retinal Edema ◽  
Chronic Central Serous Chorioretinopathy ◽  
Intravitreal Bevacizumab Injection ◽  
Micropulse Laser

Purpose. Subthreshold diode micropulse laser (SDM) treatment is believed to be safe method of treating clinical entities involving retinal edema. We present a case of serous edematous reaction of the retina to SDM treatment.Methods. Case report.Results. A patient with chronic central serous chorioretinopathy (CSCR) was treated with SDM Yellow multispot laser. Procedure had been preceded by careful titration of the laser power, which after achieving of the threshold parameter was decreased by 50%. The follow-up visit two days after treatment revealed significant central retinal edema and subretinal fluid. Fundus autofluorescence image showed thermal reaction from the RPE in the form of small spots of hyperfluorescence corresponding to the laser multispot pattern used for treatment. Retinal edema resolved after topical bromfenac and single intravitreal bevacizumab injection. Slight pigmentary reaction from the RPE persisted.Conclusion. In the treatment of CSCR, there is a need to significantly reduce threshold SDM power parameters or simply use very low power without titration.

scholarly journals Comparison of 532 nm Micropulse Green Laser versus Continuous-Wave 532 nm Green Laser in Chronic Central Serous Chorioretinopathy: Long-Term Follow-Up

2020 ◽  
Vol 2020 ◽  
pp. 1-5 ◽  
Author(s):  
Katarzyna Piasecka ◽  
Piotr Gozdek ◽  
Mariusz Maroszyński ◽  
Dominik Odrobina
Keyword(s):  
Central Serous Chorioretinopathy ◽  
Continuous Wave ◽  
Subretinal Fluid ◽  
Green Laser ◽  
Chronic Central Serous Chorioretinopathy ◽  
Micropulse Laser ◽  
Group A ◽  
Group B ◽  
532 Nm

The aim of this study was to analyze the efficacy of micropulse laser treatment (MLT) compared with the continuous-wave laser (CL) in treating eyes with chronic central serous chorioretinopathy (CSC) in a 12-month follow-up study. Methods: A retrospective observational study included 51 eyes with chronic CSC; 35 eyes were treated with MLT (Group A), and 16 eyes were treated with CL (Group B). We analyzed the best corrected visual acuity (BCVA) and retinal microstructural changes in spectral optical coherence tomography before the treatment, one and twelve months after the laser procedure. Results: The final mean BCVA was 0.89 ± 0.13 in Group A and 0.71 ± 0.17 in Group B. Photoreceptor length decreased significantly in both groups and amounted 61.2 μm in Group A and 42.9 μm in Group B one year after the treatment. Complete absorption of subretinal fluid twelve months after the laser procedure was noted in 74.3% eyes in Group A and in 87.5% eyes in group B. Hyper-reflective subretinal deposits were observed in 10/35 eyes in Group A but in 15/16 eyes in Group B on the final follow-up visit. Conclusion. MLT-treated patients showed better functional and microstructural results than patients treated with CL.

Chronic Central Serous Chorioretinopathy; Signs, Diagnosis and Treatment

2020 ◽  
pp. 104-111
Keyword(s):  
Central Serous Chorioretinopathy ◽  
Pigment Epithelium ◽  
Fundus Autofluorescence ◽  
Retinal Pigment ◽  
Subretinal Fluid ◽  
Fluid Accumulation ◽  
Fundus Fluorescein Angiography ◽  
Blurred Vision ◽  
Chronic Central Serous Chorioretinopathy

Central serous chorioretinopathy (CSCR) is a maculopathy characterized by the separation of the neurosensory layer as a result of fluid accumulation between the retinal pigment epithelium (RPE) and the photoreceptor layer. Classically it is classified as acute and chronic forms. When the disease lasts longer than 4-6 months, it is called a chronic form and comprises 15% of all CSCR cases. Although the exact etiology is unknown; studies emphasize changes in choroidal circulation causing choroidal ischemia and vascular hyperpermeability as well as subretinal fluid accumulation due to deterioration pump function of RPEs. Subretinal fluid accumulation can lead to photoreceptor dysfunction and loss of vision. Classical findings in patients are a decrease in visual acuity, blurred vision, metamorphopsia, micropsia, disturbance in color vision and dark adaptation, and scotomas. Diagnosis and follow-up depend on fundoscopy as well as imaging. Optical coherent tomography is the primary method. Fundus autofluorescence (FAF) is useful in defining RPE changes noninvasively. Fundus fluorescein angiography (FFA) shows the source of leakage. In recurrent, unresolved and chronic cases, OCT, FAF, FFA, and indocyanine green angiography can be used all together to manage the disease, to follow-up its extension, and to diagnose possible neovascular as well as polypoidal component. For the treatment of chronic CSCR patients, besides medical treatments such as carbonic anhydrase inhibitors, mineralocorticoid receptor, and glucocorticoid antagonists and intravitreal vascular endothelial growth factor antagonist (Anti-VEGF) injections, half-dose photodynamic therapy and subthreshold micropulse laser treatment are used. Prospective, controlled trials with large series for the treatment of chronic CSCR warranted.

Intravitreal Bevacizumab for Treatment of Chronic Central Serous Chorioretinopathy

2009 ◽  
Vol 19 (4) ◽  
pp. 613-617 ◽  
Author(s):  
Karen B. Schaal ◽  
Alexandra E. Hoeh ◽  
Alexander Scheuerle ◽  
Florian Schuett ◽  
Stefan Dithmar
Keyword(s):  
Repeated Measures ◽  
Central Serous Chorioretinopathy ◽  
Retinal Thickness ◽  
Statistical Significance ◽  
Subretinal Fluid ◽  
Intravitreal Bevacizumab ◽  
Intravitreal Injections ◽  
Central Retinal Thickness ◽  
Chronic Central Serous Chorioretinopathy

Purpose To evaluate the short-term safety and efficacy of intravitreal bevacizumab for the treatment of intraretinal or subretinal fluid accumulation secondary to chronic central serous chorioretinopathy (CSC). Methods Twelve patients were treated with intravitreal injections of 2.5 mg bevacizumab at 6-to 8-week intervals until intraretinal or subretinal fluid resolved. Observation procedures were Early Treatment Diabetic Retinopathy Study best-corrected visual acuity (BCVA), ophthalmic examination, and optical coherence tomography (OCT), performed at 6- to 8-week intervals. Fluorescein angiography was performed at baseline visit and thereafter depending on clinical and OCT findings. Multivariate analysis of variance with repeated measures was used to calculate a statistical significance of change in BCVA and mean central retinal thickness, which were the main outcome measures. SAS statistical software was used for analyses. Results Patients received 2±1 intravitreal injections of bevacizumab on average during a follow-up of 24±14 weeks. Mean BCVA increased by 2±2 lines; the change in BCVA (log-MAR) was significant (p<0.02). Mean central retinal thickness decreased significantly over follow-up (p<0.05), with 6 patients (50%) showing complete resolution of subretinal fluid. Conclusions Anatomic and functional improvement following intravitreal bevacizumab injections suggest that vascular endothelial growth factor (VEGF) may be involved in fluid leakage in patients with chronic CSC. The results suggest a possible role for anti-VEGF agents in the treatment of chronic CSC. Further evaluation of intravitreal bevacizumab for chronic CSC in controlled randomized studies is warranted.

Subthreshold Micropulse Laser (577 nm) Treatment in Chronic Central Serous Chorioretinopathy

2015 ◽  
Vol 234 (4) ◽  
pp. 189-194 ◽  
Author(s):  
Paula Scholz ◽  
Lebriz Ersoy ◽  
Camiel J.F. Boon ◽  
Sascha Fauser
Keyword(s):  
Visual Acuity ◽  
Retrospective Study ◽  
Central Serous Chorioretinopathy ◽  
Retinal Thickness ◽  
Imaging Modality ◽  
Subretinal Fluid ◽  
Chronic Central Serous Chorioretinopathy ◽  
Micropulse Laser ◽  
Subthreshold Micropulse Laser

Purpose: To assess treatment with a 577-nm subthreshold micropulse laser (SML) in patients with chronic central serous chorioretinopathy (cCSC). Methods: This retrospective study included 38 patients treated with a 577-nm SML (Supra Scan; Quantel Medical) for cCSC. We included a subgroup of 18 patients with persistent subretinal fluid (SRF) after photodynamic therapy (PDT). Assessment included visual acuity (VA), central retinal thickness (CRT) and resolution of SRF. Results: At the last follow-up (mean 5 months), 74% of patients responded to therapy. The CRT decreased after treatment (mean CRT -115 µm, p < 0.001) and VA improved (mean logMAR -0.06, p = 0.039). No laser burns were detected with any imaging modality. In the subgroup of patients resistant to PDT, 61% of patients responded to therapy with a decrease in CRT (mean CRT -75 µm, p = 0.019). Conclusions: The 577-nm SML is an effective treatment for cCSC even in patients without sufficient improvement after PDT.

Yellow (577 nm) micropulse laser versus half-dose verteporfin photodynamic therapy in eyes with chronic central serous chorioretinopathy: results of the Pan-American Collaborative Retina Study (PACORES) Group

2018 ◽  
Vol 102 (12) ◽  
pp. 1696-1700 ◽  
Author(s):  
Jose A Roca ◽  
Lihteh Wu ◽  
Jans Fromow-Guerra ◽  
Francisco J Rodríguez ◽  
Maria H Berrocal ◽  
...  
Keyword(s):  
Photodynamic Therapy ◽  
Central Serous Chorioretinopathy ◽  
Intravitreal Bevacizumab ◽  
Spot Size ◽  
Chronic Central Serous Chorioretinopathy ◽  
Adequate Treatment ◽  
Micropulse Laser ◽  
Half Dose ◽  
The Mean

PurposeTo compare the functional and anatomical outcomes of eyes with chronic central serous chorioretinopathy treated with yellow micropulse (MP) laser versus half-dose verteporfin photodynamic therapy (PDT).MethodsThis is a multicentre, retrospective comparative study of 92 eyes treated with yellow MP laser (duty cycle of 5%, zero spacing between spots, spot size varied from 100 to 200 µm, power varied from 320 to 660 mW, and the pulse burst duration was 200 ms) and 67 eyes treated with PDT (half-dose verteporfin (3 mg/m2) infused over 10 min), followed by laser activation for 83 s. Spot sizes varied from 400 to 2000 µm.ResultsIn the MP group, at 12 months of follow-up, the mean best corrected visual acuity (BCVA) improved from the logarithm of the minimum angle of resolution (logMAR) of 0.41±0.27 at baseline to 0.21±0.26 (P<0.0001), 48.9% (45/92) of eyes had an improvement of ≥3 lines of BCVA from baseline, 48.9% (45/92) of eyes remained within 2 lines of baseline BCVA, and only 2.2% (2/92) of eyes lost ≥3 lines of BCVA from baseline. In the PDT group, at 12 months of follow-up, the mean BCVA changed from logMAR of 0.50±0.34 at baseline to 0.47±0.34 (P=0.89), 19% (13/67) of eyes had an improvement of ≥3 lines of BCVA from baseline, 73% (49/67) of eyes remained within 2 lines of baseline BCVA, and 7% (5/67) of eyes lost ≥3 lines of BCVA from baseline. There were no adverse events attributable to the yellow MP laser treatment. One eye in the PDT group developed choroidal neovascularisation, which was treated with three intravitreal bevacizumab injections.ConclusionsBoth PDT and MP are effective in restoring the macular anatomy. In places where PDT is not available, yellow MP laser may be an adequate treatment alternative.

Results of One-Year Follow-Up Examinations after Intravitreal Bevacizumab Administration for Chronic Central Serous Chorioretinopathy

2011 ◽  
Vol 225 (1) ◽  
pp. 37-40 ◽  
Author(s):  
Maiko Inoue ◽  
Kazuaki Kadonosono ◽  
Yoichiro Watanabe ◽  
Satoshi Kobayashi ◽  
Shin Yamane ◽  
...  
Keyword(s):  
Central Serous Chorioretinopathy ◽  
Intravitreal Bevacizumab ◽  
Chronic Central Serous Chorioretinopathy ◽  
One Year

scholarly journals Comprehensive evaluation of intravitreal conbercept versus half-dose photodynamic therapy for chronic central serous chorioretinopathy

2021 ◽  
Vol 14 (5) ◽  
pp. 719-724
Author(s):  
Jian-Bo Mao ◽  
◽  
Chen-Yi Liu ◽  
Yun Zhang ◽  
Jing-Jing Lin ◽  
...  
Keyword(s):  
Photodynamic Therapy ◽  
Central Serous Chorioretinopathy ◽  
Comprehensive Evaluation ◽  
Subretinal Fluid ◽  
Chronic Central Serous Chorioretinopathy ◽  
Treatment Groups ◽  
Full Resolution ◽  
Long Term Effect ◽  
Half Dose

AIM: To compare the safety and efficacy of conbercept intravitreal injection and half-dose photodynamic therapy (PDT) in treating chronic central serous chorioretinopathy (CSC). METHODS: This study was retrospective. Thirty-seven patients (37 eyes) with chronic CSC received conbercept injections while 57 patients (57 eyes) were treated with half-dose PDT. All subjects were followed in 6mo. Outcome measures included change in best-corrected visual acuity (BCVA), central macular thickness (CMT), subfoveal choroidal thickness (SFCT), and resolution of subretinal fluid (SRF). RESULTS: There was no adverse event observed in either treatment group. At the 6-month follow-up, 26 eyes (70.3%) in the conbercept group and 54 eyes (94.7%) in the half-dose PDT group (P&#x003C;0.05) reached full resolution of SRF. The mean logarithm of the minimum angle of resolution (logMAR) BCVA significantly improved (P&#x003C;0.001) in both treatment groups with better outcome at early phase in the half-dose PDT group (2wk, 1, and 2mo, P&#x003C;0.05). All subjects experienced significant CMT improvement (P&#x003C;0.001) with no statistical difference between the two groups (P&#x003E;0.05). The SFCT also improved in all subjects (P&#x003C;0.001) with better outcome in the half-dose PDT group (P&#x003C;0.05). CONCLUSION: Both intravitreal conbercept and half-dose PDT are safe to use in treating chronic CSC. By 6mo, both treatment groups are efficacious in improving BCVA, reducing CMT and SFCT, and resolving SRF in eyes with chronic CSC. Half-dose PDT may show better outcome at initial phase of treatment in chronic CSC. Longer follow-up period is necessary to study for long-term effect and safety.

scholarly journals Short Term Presence of Subretinal Fluid in Central Serous Chorioretinopathy Affects Retinal Thickness and Function

2020 ◽  
Vol 9 (11) ◽  
pp. 3429
Author(s):  
Maciej Gawęcki ◽  
Agnieszka Jaszczuk ◽  
Andrzej Grzybowski
Keyword(s):  
Central Serous Chorioretinopathy ◽  
Retinal Thickness ◽  
Fundus Autofluorescence ◽  
Disease Onset ◽  
Subretinal Fluid ◽  
First Episode ◽  
Inclusion Criteria ◽  
Duration Of Symptoms ◽  
Short Period

Background: Acute central serous chorioretinopathy (CSCR), with subretinal fluid (SRF) resolving spontaneously within a few months from disease onset, has been considered as a benign and self-limiting disease for many years. This study sought to discover if a short presence of SRF can result in morphological and functional damage to the retina. Materials and methods: The study included patients treated by subthreshold diode micropulse laser (SDM) application for acute CSCR at the Dobry Wzrok Ophthalmological Clinic between January 2018 and November 2019. Inclusion criteria were: first episode of CSCR; duration of symptoms of two months or less; complete resolution of subretinal fluid (SRF) after a single session of SDM; and a lack of any retinal pathology, previous CSCR episode, significant anisometropia or amblyopia in the collateral eye. Fifteen patients fulfilled the inclusion criteria, including 13 males and two females aged 42.3 ± 9.5 years. The mean duration of symptoms before treatment was 4.7 ± 1.3 weeks on average. Baseline and follow-up examinations were performed in both the affected and collateral eyes and included best-corrected visual acuity (BCVA); spectral-domain optical coherent tomography measurements such as central retinal thickness (CRT) and minimal foveal thickness (MFT) (at the follow-up visit only); fluorescein angiography (at presentation only) and fundus autofluorescence. The first follow-up visit, when the total resolution of SRF was noted, was conducted between 8 and 12 weeks after SDM. Results: Resolved CSCR eyes had significantly poorer BCVA, CRT, and MFT findings in comparison with healthy collateral eyes (respectively, 0.11 +/− 0.1 vs. 0.01 +/− 0.04 logMAR; 238.80 +/− 23.39 vs. 264.87 +/− 21.22 µm and 178.93 +/− 16.88 vs. 199.47 +/− 17.87 µm) despite the short period of CSCR duration (maximum of 14 ± 2.15 weeks on average). Conclusion: Short presence of SRF typical for acute CSCR can affect retinal function and morphology resulting in poorer visual outcome.

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