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.

scholarly journals Functional and morphological retinal impairment following resolved chronic central serous chorioretinopathy

2018 ◽  
Author(s):  
Maciej Gawęcki ◽  
Agnieszka Jaszczuk-Maciejewska ◽  
Anna Jurska-Jaśko ◽  
Małgorzata Kneba ◽  
Andrzej Grzybowski
Keyword(s):  
Visual Acuity ◽  
Central Serous Chorioretinopathy ◽  
Retinal Thickness ◽  
Subretinal Fluid ◽  
Central Retinal Thickness ◽  
Morphological Parameters ◽  
Chronic Central Serous Chorioretinopathy ◽  
Micropulse Laser ◽  
Corrected Visual Acuity ◽  
Best Corrected Visual Acuity

Abstract Purpose Central serous chorioretinopathy is a complex ocular entity that, in its chronic form, can lead to serious visual impairment and morphological damage to the retina. The aim of the current retrospective study was to evaluate the damage present after long-standing but resolved central serous chorioretinopathy. Correlations between measurable factors—for example, duration of the disease, baseline retinal morphological parameters, or patient age and/or their degree of impairment—were also assessed. Materials and methods Thirty-two eyes with chronic central serous chorioretinopathy in which complete resolution of subretinal fluid was achieved after subthreshold micropulse laser treatment were analyzed according to final best-corrected visual acuity and retinal morphological parameters as measured by spectral optical coherence tomography with angiography option (OCTA). Results were compared with the outcomes of a control group. Statistical analysis included regarding correlation between final visual acuity and final central retinal thickness and retinal and functional parameters prior to treatment. Results Final best-corrected visual acuity after chronic central serous chorioretinopathy was 0.23 logMAR (0.6 Snellen) and central retinal thickness was 39.32 µm smaller than in controls. No correlation was found between final visual acuity and retinal thickness and duration of the disease, patient age, and baseline morphological retinal parameters. OCTA scans revealed impaired choroidal perfusion even following resolution of the disease. Conclusion Chronic central serous chorioretinopathy is a potentially damaging clinical entity that results in serious visual impairment, retinal thinning, and choroidal flow defects. No significant correlation between duration of central serous chorioretinopathy and amount of visual deficit has been found, therefore it is possible that the biggest damage occurs within the first months of active chorioretinopathy. Keywords: chronic central serous chorioretinopathy, micropulse laser, central retinal thickness, subretinal fluid

scholarly journals Impairment of visual acuity and retinal morphology following resolved chronic central serous chorioretinopathy

2019 ◽  
Author(s):  
Maciej Gawęcki ◽  
Agnieszka Jaszczuk-Maciejewska ◽  
Anna Jurska-Jaśko ◽  
Małgorzata Kneba ◽  
Andrzej Grzybowski
Keyword(s):  
Visual Acuity ◽  
Central Serous Chorioretinopathy ◽  
Retinal Thickness ◽  
Subretinal Fluid ◽  
Morphological Parameters ◽  
Healthy Individuals ◽  
Chronic Central Serous Chorioretinopathy ◽  
Micropulse Laser ◽  
Corrected Visual Acuity ◽  
Best Corrected Visual Acuity

Abstract Purpose Central serous chorioretinopathy(CSCR) is a complex ocular entity that, in its chronic form, can lead to serious visual impairment and morphological damage to the retina. The aim of the current retrospective study was to evaluate the damage present after long-standing but resolved central serous chorioretinopathy and refer it to healthy individuals. Correlations between measurable factors—for example, duration of the disease, baseline retinal morphological parameters, or patient age and/or their degree of impairment—were also assessed. Materials and methods The study group consisted of thirty-two eyes (13 female and 19 male, mean age 49.6 years SD +/- 10.5) with chronic central serous chorioretinopathy ( mean duration 18.9 months SD +/- 15.4) in which complete resolution of subretinal fluid was achieved after subthreshold micropulse laser treatment. Inclusion criterion was a lack of subretinal fluid within the whole area of the central retina scanned by the spectral domain optical coherence tomography. The group was extracted out of 51 cases of chronic CSCR that were treated with that method. They were analyzed according to final best-corrected visual acuity and retinal morphological parameters as measured by spectral optical coherence tomography with angiography option (OCTA). Results were compared with the outcomes of a control group, which consisted of 40 eyes of healthy individuals with full distance visual acuity (0.0 logMAR, 1.0 Snellen) never treated with subthreshold micropulse laser. Statistical analysis included regarding correlation between final visual acuity and final central retinal thickness and retinal and functional parameters prior to treatment. Results Final best-corrected visual acuity after chronic central serous chorioretinopathy was 0.23 logMAR (0.6 Snellen) and central retinal thickness was 39.32 µm smaller than in controls. No correlation was found between final visual acuity and retinal thickness and duration of the disease, patient age, and baseline morphological retinal parameters. OCTA scans revealed impaired choriocapillaries flow signal even following resolution of the disease. Conclusion Chronic central serous chorioretinopathy is a potentially damaging clinical entity that results in serious visual impairment, retinal thinning, and choroidal flow defects. Further research is needed to determine precisely the timepoint of this damage.

scholarly journals Impairment of visual acuity and retinal morphology following resolved chronic central serous chorioretinopathy

2019 ◽  
Author(s):  
Maciej Gawęcki ◽  
Agnieszka Jaszczuk-Maciejewska ◽  
Anna Jurska-Jaśko ◽  
Małgorzata Kneba ◽  
Andrzej Grzybowski
Keyword(s):  
Visual Acuity ◽  
Central Serous Chorioretinopathy ◽  
Retinal Thickness ◽  
Subretinal Fluid ◽  
Morphological Parameters ◽  
Healthy Individuals ◽  
Chronic Central Serous Chorioretinopathy ◽  
Micropulse Laser ◽  
Corrected Visual Acuity ◽  
Best Corrected Visual Acuity

Abstract Purpose Central serous chorioretinopathy(CSCR) is a complex ocular entity that, in its chronic form, can lead to serious visual impairment and morphological damage to the retina. The aim of the current retrospective study was to evaluate the damage present after long-standing but resolved central serous chorioretinopathy and refer it to healthy individuals. Correlations between measurable factors—for example, duration of the disease, baseline retinal morphological parameters, or patient age and/or their degree of impairment—were also assessed. Materials and methods The study group consisted of thirty-two eyes (13 female and 19 male, mean age 49.6 years SD +/- 10.5) with chronic central serous chorioretinopathy ( mean duration 18.9 months SD +/- 15.4) in which complete resolution of subretinal fluid was achieved after subthreshold micropulse laser treatment. Inclusion criterion was a lack of subretinal fluid within the whole area of the central retina scanned by the spectral domain optical coherence tomography. The group was extracted out of 51 cases of chronic CSCR that were treated with that method. They were analyzed according to final best-corrected visual acuity and retinal morphological parameters as measured by spectral optical coherence tomography with angiography option (OCTA). Results were compared with the outcomes of a control group, which consisted of 40 eyes of healthy individuals with full distance visual acuity (0.0 logMAR, 1.0 Snellen) never treated with subthreshold micropulse laser. Statistical analysis included regarding correlation between final visual acuity and final central retinal thickness and retinal and functional parameters prior to treatment. Results Final best-corrected visual acuity after chronic central serous chorioretinopathy was 0.23 logMAR (0.6 Snellen) and central retinal thickness was 39.32 µm smaller than in controls. No correlation was found between final visual acuity and retinal thickness and duration of the disease, patient age, and baseline morphological retinal parameters. OCTA scans revealed impaired choriocapillaries flow signal even following resolution of the disease. Conclusion Chronic central serous chorioretinopathy is a potentially damaging clinical entity that results in serious visual impairment, retinal thinning, and choroidal flow defects. Further research is needed to determine precisely the timepoint of this damage.

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.

scholarly journals The Personalized Approach to the Chronic Central Serous Chorioretinopathy Treatment Based on the Navigated Micropulse Laser Technology

2019 ◽  
Vol 15 (4) ◽  
pp. 394-404
Author(s):  
P. L. Volodin ◽  
A. V. Doga ◽  
E. V. Ivanova ◽  
V. A. Pismenskaya ◽  
Iu. I. Kukharskaya ◽  
...  
Keyword(s):  
Visual Acuity ◽  
Laser Treatment ◽  
Central Serous Chorioretinopathy ◽  
Retinal Thickness ◽  
Retinal Sensitivity ◽  
Individual Selection ◽  
Chronic Central Serous Chorioretinopathy ◽  
Energy Parameters ◽  
Micropulse Laser ◽  
Selection Of

The Purpose— to develop the technology and to evaluate the clinical results of personalized laser treatment of patients with chronic central serous chorioretinopathy (CSC) in a micropulse mode with individual selection of energy parameters on the navigation system Navilas 577s.Patients and Methods. 19 patients (22 eyes) with CSC after micropulse laser treatment were analyzed. The initial best corrected visual acuity (BCVA) was 0.4 to 1.0. According to OCT, the height of the  detachment of the neurosensory retina varied from 83 to 259 microns. Retinal sensitivity of the central zone was from 20.2 to 29.7 dB. Before laser treatment were individually selected the optimal energy parameters for each patient. The treatment was performed on a Navilas 577s laser system. The follow-up were 1 and 3 months.Results. 1 month after treatment the positive dynamics of functional and anatomical results in all patients was observed. Mean BCVA increased in the group to 0.81 ± 0.04. The central retinal sensitivity raised on average in the group up to 25.7 ± 0.6 dB. After 3 months, mean BCVA was 0.96 ± 0.02. Mean central retinal sensitivity increased to 26.4 ± 0.57 dB. The study revealed a high correlation between visual acuity and the central retinal thickness (0.72) and medium correlation between foveal retinal sensitivity and central retinal thickness in fovea (0.60), respectively. The correlation among visual acuity, retinal sensitivity and the symptom’s duration of the disease is negative medium (-0.63) and significant (-0.72), respectively.Conclusions. The developed personalized technology of laser treatment of chronic central serous chorioretinopathy with a micropulse mode with an individual selection of energy parameters on the Navilas 577s navigation system showed high clinical efficiency and safety. It has been established that in the course of the longstanding duration of the disease irreversible changes in the chorioretinal complex structure occured, thinning of the foveal photoreceptors layer leading to a decrease in the central retinal sensitivity and visual acuity, which substantiate the necessity for early and maximally functional-saving treatment.

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.

Eplerenone for the treatment of chronic central serous chorioretinopathy: 3-year clinical experience

2019 ◽  
Vol 104 (2) ◽  
pp. 182-187 ◽  
Author(s):  
Daniel S Petkovsek ◽  
Daniel G Cherfan ◽  
Felipe F Conti ◽  
Grant L Hom ◽  
Justin P Ehlers ◽  
...  
Keyword(s):  
Visual Acuity ◽  
Central Serous Chorioretinopathy ◽  
Subretinal Fluid ◽  
First Year ◽  
Chronic Central Serous Chorioretinopathy ◽  
Mineralocorticoid Receptor Antagonist ◽  
Institutional Review ◽  
Central Subfield Thickness ◽  
Small Cohort

Background/aimsThe efficacy of mineralocorticoid receptor antagonist eplerenone to treat chronic central serous chorioretinopathy (CSCR) has been established. However, previous studies have been limited by small cohort size and short follow-up duration. This study aims to report 3-year clinical outcomes of patients treated with eplerenone for chronic CSCR.MethodsInstitutional review board-approved retrospective chart analysis at a single institution from 2012 to 2018. Baseline best-corrected visual acuity and anatomical measurements related to degree of subretinal fluid (SRF) were collected at eplerenone initiation. Follow-up data were collected at the closest date to 12, 24 and 36 months.ResultsData were obtained for 100 eyes of 83 patients at 1-year (mean 11.18 ± 4.00 months), 49 eyes at 2-year (24.01 ± 3.33 months) and 33 eyes at 3-year (mean 35.5 ± 7.89 months) follow-up visits. The rate of complete SRF resolution was 31%, 28% and 33%, respectively. At final follow-up, logarithm of the minimum angle of resolution visual acuity change from baseline was +0.10 ± 0.24 (p = 0.130). Average change from baseline at final follow-up for central subfield thickness was −97 ± 140.6 µm (p < 0.001), cube volume was –1.07 ± 1.71 mm3 (p < 0.001), macular thickness –28. 5 ± 47.5 µm (p < 0.001), maximum SRF height was −95.6 ± 160.5 µm (p < 0.001) and maximum SRF diameter was −1169.0 ± 1638.7 µm (p = 0.008).ConclusionAnatomical improvement occurs primarily within the first year of eplerenone treatment for chronic CSCR.

scholarly journals Anatomical Retinal Changes after Photodynamic Therapy in Chronic Central Serous Chorioretinopathy

2018 ◽  
Vol 2018 ◽  
pp. 1-4 ◽  
Author(s):  
María Pilar Ruiz-del-Tiempo ◽  
Pilar Calvo ◽  
Antonio Ferreras ◽  
Jesús Leciñena ◽  
Luis Pablo ◽  
...  
Keyword(s):  
Photodynamic Therapy ◽  
Central Serous Chorioretinopathy ◽  
Retinal Thickness ◽  
Outer Nuclear Layer ◽  
Subretinal Fluid ◽  
Chronic Central Serous Chorioretinopathy ◽  
One Year ◽  
Mean Time ◽  
Sd Oct

Purpose. To evaluate anatomical retinal changes measured by spectral-domain optical coherence tomography (SD-OCT), after applying photodynamic therapy (PDT) for treatment of chronic central serous chorioretinopathy (CSC). Methods. A retrospective analysis was conducted on 43 patients (48 eyes) with chronic CSC treated with PDT. Visual acuity (VA), central retinal thickness (CRT), outer nuclear layer (ONL) thickness, subretinal fluid (SRF), and photoreceptor ellipsoid zone (EZ) measured by SD-OCT were collected at baseline and at 3, 6, and 12 months after PDT. Differences between normally distributed variables were calculated by a paired-sample t-test; p<0.05 was considered statistically significant. Results. Mean age was 50 ± 9.8 years. Mean time from diagnosis to PDT was 12.5 months. Baseline VA was 0.51 ± 0.24 and significantly improved (p<0.001) to 0.74 ± 0.26 one year after PDT. CRT and SRF significantly decreased (p<0.001) at 3, 6, and 12 months after treatment. ONL thickness and EZ did not significantly change at any point during follow-up. Conclusions. Not significant changes were found in the ONL or EZ 12 months after PDT.

scholarly journals Safety of various parameter sets with navigated microsecond pulsing laser in central serous chorioretinopathy

2021 ◽  
Vol 7 (1) ◽  
Author(s):  
Jay Chhablani ◽  
Gagan Kalra ◽  
Lubna Alkwatli ◽  
Bernd Fassbender ◽  
Francesca Amoroso ◽  
...  
Keyword(s):  
Visual Acuity ◽  
Adverse Events ◽  
Central Serous Chorioretinopathy ◽  
Retinal Thickness ◽  
Subretinal Fluid ◽  
Central Retinal Thickness ◽  
Duration Of Symptoms ◽  
Corrected Visual Acuity ◽  
Best Corrected Visual Acuity

Abstract Background Subthreshold microsecond pulsing laser is an increasingly common treatment approach for central serous chorioretinopathy. However, there is no literature available on the safety of microsecond laser using different fluence settings in this disease. While many publications can be obtained from conventional microsecond pulsing lasers, few parameter sets are published with the navigated microsecond pulsing laser. Therefore, this study aims to investigate the safety of different parameter sets in subthreshold microsecond pulsing laser treatments. Methods In this retrospective chart review, consecutive patients with central serous chorioretinopathy (> 3 months duration of symptoms) treated with navigated subthreshold microsecond pulsing laser and a follow up of at least five months after microsecond laser application were included. For each patient, the treatment parameters, plan layout, and adverse events related to laser were evaluated. Secondary outcomes included best-corrected visual acuity and anatomical improvements (central retinal thickness). Results One hundred and one eyes were included in the observation and followed for a mean of 10 months (range 5–36). Although a larger range of parameter sets and fluence settings have been used, no patient demonstrated adverse events from navigated microsecond pulsing laser. While 88% of the cases demonstrated stability, 13 cases lost five or more letters due to the persistence of the subretinal fluid. In mean, a best-corrected visual acuity improvement of 0.07logMar (± 0.2) was seen (p = 0.02). In 51% of the patients, a statistically significant improvement of the central retinal thickness was noted at the last follow-up with a mean thickness reduction of 70 µm (± 143) (p < 0.01). Conclusion In conclusion, none of the used parameter sets lead to tissue damage (when using a cautious titration) and, in summary, lead to an improvement in subretinal fluid and improvement in visual acuity. However, further prospective studies are needed to correctly identify the dependency of the treatment strategy on the outcome criteria.

scholarly journals Effects of Intravitreal Aflibercept in Patients with Central Serous Chorioretinopathy

2020 ◽  
Vol 36 (4) ◽  
Author(s):  
Ali Afzal Bodla ◽  
Muhammad Afzal Bodla ◽  
Syeda Minahil Kazmi ◽  
Ayema Moazzam
Keyword(s):  
Visual Acuity ◽  
Intravitreal Injection ◽  
Central Serous Chorioretinopathy ◽  
Retinal Thickness ◽  
Case Series ◽  
Central Retinal Thickness ◽  
Chronic Central Serous Chorioretinopathy ◽  
Intravitreal Aflibercept ◽  
The Mean

Purpose:  The purpose of this study is to assess the efficacy of intravitreal injection of Afliberceptin patients with chronic central serous chorioretinopathy (CSCR). Study Design:  Interventional case series. Place and Duration of Study: Multan Medical and Dental Centre and Bodla Eye Care from February 2019 to February 2020. Methods:  This study was conducted on fifteen eyes with sub-acute to chronic central serous chorioretinopathy. All patients who had undergone previous treatment with laser photocoagulation, intravitreal triamcinolone, or bevacizumab in past 3 months, history of glaucoma (intraocular pressure > 21 mmHg), patients who lost to follow-up, and those with previously vitrectomized eyes were excluded. Patients were treated with a single dose of intravitreal injection of Aflibercept (0.5 mg/0.05 ml). Visual acuity with Log MAR chart and central retinal thickness were studied before and after the injection. Results:  The mean age of the patients was 30.46 years ± 9 years. After one month of intravitreal Aflibercept injection, visual acuity improved from 0.32 Log MAR to 0.173 log MAR and at 3 months (the last follow-up) it was 0.206 Log MAR. Central retinal thickness (CRT) improved from 437 ± 82 µm (at the time of presentation) to 349 ± 67 µm at 1 month post injection. At the last follow-up the mean CRT decreased to 309 ± 121 µm. Except for two eyes, all eyes showed visual improvement. These two eyes had a higher CRT as compared to other participants. Conclusion:  Intravitreal injection of Afliberceptis effective in improving BCVA and decreasing the central retinal thickness in patients central serous chorioretinopathy. Key Words:  Central retinal thickness, Central Serous chorioretinopathy, Aflibercept.

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