scholarly journals Five Years Results of Subtreshold Yellow Micropulse Laser Treatment in Chronic Central Serous Chorioretinopathy: Could there be any markers of response to treatment?

Author(s):  
hatice selen sönmez kanar
2019 ◽  
Vol 15 (4) ◽  
pp. 394-404
Author(s):  
P. L. Volodin ◽  
A. V. Doga ◽  
E. V. Ivanova ◽  
V. A. Pismenskaya ◽  
Iu. I. Kukharskaya ◽  
...  

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.


2017 ◽  
Vol 4 (2) ◽  
pp. 96
Author(s):  
Mansur Ali Khan ◽  
Sadhana Joshi ◽  
Ashutosh Gupta

<p class="abstract"><strong>Background:</strong> Central serous chorioretinopathy (CSC) is an idiopathic condition with an illdefined aetiopathogenesis and no clearly effective treatment. The choice of treatment include thermal laser photocoagulation, photodynamic therapy (PDT), subthreshold micropulse laser and anti VEGF<span lang="EN-IN">. </span></p><p class="abstract"><strong>Methods:</strong> In a prospective nonrandomized pilot trial we evaluated two of these modalities subthreshold micropulse laser treatment and intravitreal anti VEGF in 20 consecutive cases of non-resolving CSC of duration 3 to 6 months with vision below 6/12 treated with either Bevacizumab for leakage close to fovea or subthreshold micropulse 810 diode laser for extrafoveal leakage (10% duty cycle, 100 µ spot size) as seen on fluorescein angiography<span lang="EN-IN">.</span></p><p class="abstract"><strong>Results:</strong> At 6 months follow up complete resolution was seen in 9/10 in laser and 6/10 in Avastin group. The mean visual acuity improved from  Log MAR 0.61 ± 0.17  at baseline to Log MAR 0.07± 0.11  post treatment in laser group and from Log MAR 0.59 ± 0.17  to Log MAR 0.18 ± 0.09   in the Avastin group . Similarly mean central macular thickness decreased from 607 µ ± 162.1 to 206 µ ± 55   in laser group and from 601 µ ± 182 to 262 µ ± 75 in those receiving Avastin. Both visual outcome and resolution of serous detachment was better with Micropulse laser as compared to Bevacizumab<span lang="EN-IN">.  </span></p><p class="abstract"><strong>Conclusions:</strong> Micropulse diode laser treatment of CSC has higher rate of resolution and better visual outcome as compared to Bevacizumab injections.</p>


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