Treatment of resistant chronic central serous chorioretinopathy via platelet-rich plasma with electromagnetic stimulation

2020 ◽  
Author(s):  
Umut Arslan ◽  
Emin Özmert

Background: To evaluate whether subtenon injection of platelet-rich plasma (PRP) with retinal electromagnetic stimulation (rEMS) is effective in therapy-resistant chronic central serous chorioretinopathy (CSCR). Design: Prospective, sequential. Materials & methods: The study included 22 eyes with resistant chronic CSCR. Cases receiving micropulse laser or additional photodynamic therapy, subtenon PRP, and subtenon PRP + rEMS were classified as times 1, 2 and 3, respectively. Results: At time 3, the mean best-corrected visual acuity was 85.7 and 97.0 letters before and after the procedures, respectively (p = 0.01). Submacular thickness improved by 17, 27 and 51% at times 1, 2 and 3 respectively. Conclusion: For treating resistant CSCR, subtenon PRP + rEMS should be considered as an effective and safe option. Trial Registration: ClinicalTrials.gov ID: NCT04224831

2018 ◽  
Author(s):  
Maciej Gawęcki ◽  
Agnieszka Jaszczuk-Maciejewska ◽  
Anna Jurska-Jaśko ◽  
Małgorzata Kneba ◽  
Andrzej Grzybowski

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


2015 ◽  
Vol 96 (4) ◽  
pp. 514-517
Author(s):  
A A Gilyazova ◽  
A N Samoylov ◽  
R Kh Khafiz’yanova

Aim. To assess the efficacy of laser photocoagulation treatment for patients with chronic central serous chorioretinopathy. Methods. The study included 17 eyes of 15 patients with relapse of central serous chorioretinopathy of different etiology, including 9 men. Patient’s age ranged from 34 to 55 years. Mean disease duration ranged from 3 months to 8 years. All study subjects underwent a standard ophthalmic examination including best-corrected visual acuity testing, intraocular pressure measurement, bioophthalmoscopy, color vision testing, visual field testing, optical coherence tomography, fluorescent angiography of the retina before and after the treatment. Fluorescein sodium salt (100 mg/ml, ampules of 5 ml, «Novartis Pharma» was used as a contrast. Before the treatment, neuroepithelial layer detachment height was 385.09±14.1 µm, the best-corrected visual acuity ranged from 0.41 to 0.82. The study group did not include the patients with secondary choroidal neovascularization. Diode laser with wave length of 532 nm («Carl Zeiss») was used for laser photocoagulation. The laser photocoagulation procedure was done using the following parameters: exposure time 0.05-0.1 sec, the spot diameter 100-200 µm, and the impulse energy of 100-200 mJ. Results. Significant improvement of visual acuity, disappearance of relative central scotoma proven by instrumental methods was seen in all patients. Best-corrected visual acuity was 0.91, decrease of neuroepithelial layer detachment height with adherence of all layers of the retina was reduced to 171.12±11.5 µm on the 3-5 day after laser photocoagulation. Patients were followed up from 1 to 6 months, with treatment results staying stable. Conclusion. Laser photocoagulation of a retina in treatment of chronic central serous chorioretinopathy allows to achieve encouraging morphologic and functional results.


2019 ◽  
Author(s):  
Maciej Gawęcki ◽  
Agnieszka Jaszczuk-Maciejewska ◽  
Anna Jurska-Jaśko ◽  
Małgorzata Kneba ◽  
Andrzej Grzybowski

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.


2019 ◽  
Author(s):  
Maciej Gawęcki ◽  
Agnieszka Jaszczuk-Maciejewska ◽  
Anna Jurska-Jaśko ◽  
Małgorzata Kneba ◽  
Andrzej Grzybowski

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.


2022 ◽  
Vol 11 (2) ◽  
pp. 323
Author(s):  
Minhee Kim ◽  
Seung Hee Jeon ◽  
Ji-young Lee ◽  
Seung-hoon Lee ◽  
Young-jung Roh

This retrospective study aimed to assess the safety and efficacy of selective retina therapy (SRT) with real-time feedback-controlled dosimetry (RFD) for chronic central serous chorioretinopathy (CSC) and to evaluate factors predictive of treatment response. We included 137 eyes of 135 patients with chronic CSC. SRT was performed to cover each of the leakage areas on fundus fluorescein angiography. Changes in mean best-corrected visual acuity (BCVA), central macular thickness (CMT), and subretinal fluid (SRF) height were evaluated at baseline and at 3 and 6 months after treatment. Complete SRF resolution was observed in 52.6% (72/137 eyes) and 90.5% (124/137 eyes) at 3 and 6 months, respectively. Mean BCVA (logMAR) significantly improved from 0.41 ± 0.31 at baseline to 0.33 ± 0.31 at month 6 (p < 0.001). Mean CMT significantly decreased from 347.67 ± 97.38 μm at baseline to 173.42 ± 30.95 μm at month 6 (p < 0.001). Mean SRF height significantly decreased from 187.85 ± 97.56 µm at baseline to 8.60 ± 31.29 µm after 6 months (p < 0.001). Baseline SRF height was a significant predictive factor for retreatment requirement (p = 0.008). In conclusion, SRT showed favorable anatomical outcomes in patients with chronic CSC. A higher baseline SRF height was a risk factor for retreatment.


2009 ◽  
Vol 03 (01) ◽  
pp. 71
Author(s):  
Marilita M Moschos ◽  
Michael Moschos ◽  
◽  

Purpose: To evaluate central serous chorioretinopathy (CSCR) by multifocal electroretinogram (mf-ERG). Patients and methods: Twenty-one patients (21 eyes) with unilateral CSCR were examined. Both eyes of each patient underwent complete ophthalmological examination, including measurement of best corrected visual acuity, fluorescein angiography and mf-ERG recording. Our results were compared with the corresponding findings of 33 age-matched normal volunteers. Results: At presentation, the mean retinal response density (RRD) of the affected eyes in area 1 was 50.8% lower compared with normal controls (p<0.001). After CSCR regression, the mean RRD of the affected eyes was 30.1% lower compared with normal controls (p<0.001). Six fellow unaffected eyes showed a mean RRD in area 1 equal to 12nV/deg2. Conclusion: During the acute phase of CSCR, the mean RRD of the fovea was significantly abnormal. After its regression, mf-ERG values ameliorate, but they remain significantly abnormal. Abnormal values in area 1 were also found in the unaffected eyes.


2020 ◽  
Vol 75 (6) ◽  
pp. 298-308
Author(s):  
Kateřina Manethová ◽  
Jan Ernest ◽  
Michal Hrevuš ◽  
Naďa Jirásková

Purpose: The aim of this prospective clinical study was to evaluate the anatomical and functional results of the treatment of 54 eyes with chronic form of central serous chorioretinopathy (CSC) using photodynamic therapy in a reduced (half) verteporfin (HD-PDT) dosing regimen. Materials and Methods: Our prospective study included 54 eyes of 52 patients (40 males, 12 females) at an average age of 50.1 years (median 49.5, range 30–75 years) treated at the Ophthalmology Clinic of the First Faculty of Medicine and Military University Hospital in Prague from January 2012 to January 2018 for chronic form of CSC with a minimum disease duration of 3 months. In our study, we evaluated the improvement of the best corrected visual acuity (BCVA) and central retinal thickness (CRT) before treatment and at 1, 3, 6 and 12 months after HD-PDT. Results: The mean baseline BCVA was 68.91 ± 10.5 ETDRS letters (median 71; range 35–85) and the mean baseline CRT was 385.6 ± 118.5 µm (median 367, 5 µm; range 245–1000 µm). At the end of the follow-up period, the average BCVA was 79 ± 11 ETDRS letters (median 82; range 38–93). The improvement in BCVA before and after treatment was statistically significant in all measurements (p < 0.0001). The mean CRT at the end of the follow-up period was 263.5 ± 52 µm (median 258.5 µm; range 162–404 µm). The decrease in CRT at all timepoints was statistically significant compared to baseline (p < 0.0001). In our set of patients, at the end of the follow-up period, the retinal finding was improved or stabilized in 50 eyes (92.6 %). In this study, we observed in 2 cases the development of secondary choroidal neovascularization (CNV). Conclusion: HD-PDT is a long-term safe and effective method of treating chronic forms of CSC. However, despite a reduced dose of verteporfin, complications may occur.


2019 ◽  
Vol 2019 ◽  
pp. 1-5
Author(s):  
Ghada A. Nassar ◽  
Maha M. Youssef ◽  
Lameece M. Hassan ◽  
Hebatalla S. Makled

The purpose of the study is to assess the retinal sensitivity, using microperimetry, before and after silicone removal. It included 22 patients admitted for silicone removal after vitrectomy for macula-off retinal detachment. Patients were divided into 2 groups according to the duration of silicone tamponade: Group A: <3 months (included 10 patients), and Group B: 3–6 months (included 12 patients). Retinal sensitivity was tested, using microperimetry, one day before and one month after silicone removal. The best-corrected visual acuity (in LogMAR) significantly improved postoperatively (0.69 versus 1.06 and 0.69 versus 1.07 in Groups A and B, respectively). The mean intraocular pressure (IOP) was 12.89 ± 1.05 mmHg postoperatively versus 14.89 ± 1.76 mmHg preoperatively in Group A (p=0.011) and was 13.33 ± 1.30 mmHg postoperatively versus 15.33 ± 3.11 mmHg preoperatively in Group B (p=0.008). In Group A, the mean postoperative overall retinal sensitivity was 8.70 ± 2.56 dB versus 5.68 ± 2.00 dB preoperatively (p=0.008). In Group B, it was 9.83 ± 3.36 dB versus 7.00 ± 2.55 dB (p=0.002). No statistically significant difference was found between the two groups as regards improvement in overall retinal sensitivity. We concluded that the overall retinal sensitivity significantly increased following silicone removal in both groups. This trial is registered with ISRCTN43187564.


2015 ◽  
Vol 21 (3.2) ◽  
pp. 413-416
Author(s):  
Vilma Jūratė Balčiūnienė ◽  
Rosita Lažaunykaitė

Key words: ranibizumab, age-related macular degeneration, central macular thickness. Research objective. To evaluate influence of treatment with vascular endothelial growth factor inhibitor, ranibizumab, for best corrected visual acuity and central macular thickness in patients with neovascular age-related macular degeneration. Materials and methods. In this retrospective study were included treatment – naive patients. Intravitreal injections were performed at Lithuanian University of Health Sciences Kaunas Clinics Eye clinic. In this study were analysed the 24-month morphological and functional outcomes of intravitreal ranibizumab injections. Best corrected visual acuity was meassured using the Snellen chart (Landolt’s rings C optotypes). Optical coherence tomography images were obtained using the spectral – domain OCT (NIDEK RS – 3000 Advance (NIDEK CO LTD, Japan). The central thickness measurements were obtained from macular thickness maps using the digital caliper tool. Results. In this study were included 88 patients. Best corrected visual acuity before treatment was 0.36 ± 0.22. The difference between visual acuity before and after first injection was 0.04 ± 0.22 (p = 0.03). Before fifth injection visual acuity was 0.41 ± 0.21, after – 0.46 ± 0.22 (p = 0.05). Central macular thickness before treatment was 297.81 ± 106.04 μm. The difference between central macular thickness before and after first injection was 85.21 ± 113.37 μm (p &lt; 0.001). Before second injection central macular thickness was 273.57 ± 87.49 μm, after – 234.51 ± 58.96 μm (p = 0.002). Before fourth injection central macular thickness was 237.20 ± 40.87 μm, after – 219.10 ± 42.26 μm (p = 0.04). The mean central macular thickness significantly decreased from 298.15 ± 104.78 to 229.08 ± 56.57 (p &lt; 0.001). In 24 month of treatment the average number of ranibizumab injections was 3.61 ± 1.55. Conclusions. Our study’s results showed that over 24 month best corrected visual acuity improvement was statistically significant after first and fifth injection. Baseline compared with last injection, there was not statistically significant difference. Central macular thickness improvement statistically significant was after first, second and fourth injection. There was statistically significant decreased baseline compared with the last injection. The mean number of ranibizumab injections was 3.61 ± 1.55 in 24 month.


2019 ◽  
Author(s):  
Jianbo Mao ◽  
Caiyun Zhang ◽  
Chenyi Liu ◽  
Lijun Shen ◽  
Jimeng Lao ◽  
...  

Abstract Background: To evaluate the efficacy and safety of conbercept for patients with chronic central serous chorioretinopathy (CSC). Methods: A retrospective clinical study. This study included twenty-seven patients (32 eyes) who were diagnosed with chronic CSC in our hospital from November 2015 to March 2018. All the patients received intravitreal conbercept with one intravitreal injection and pro re nata (PRN). Follow-up observations occurred at 1 week and 1, 2, 3, and 6 months after initial injection. Observed indicators included best-corrected visual acuity (BCVA), central macular thickness (CMT) and presence of subretinal fluid (SRF). Results: During the 6-month follow-up, the mean number of injections required and performed was 1.50±0.67. The BCVA at the first visit, 1-week, 1-, 2-, 3- and 6-month follow-ups after the first injection was 0.44±0.26, 0.39±0.29, 0.38±0.29, 0.33±0.29, 0.31±0.30, and 0.31±0.29, respectively. The difference between the BCVA at each follow-up and the first visit was statistically significant (F=9.717, P<0.05). CMT at the first visit, 1-week, 1-, 2-, 3- and 6- month after first injection was 323.25±158.49μm, 263.78±122.52μm, 222.34±92.46μm, 195.63±69.18μm, 189.25±68.71μm, and 200.47±86.30μm, respectively. The difference between the CMT at each follow-up and the first visit was also statistically significant (F=17.072, P<0.05). Full resolution of fluid was achieved in 7 (21.9%) eyes at 1 month, 14 (43.8%) eyes at 2 months, 19 (59.4%) eyes at 3 months and 23 (71.9%) eyes at 6 months after the initial treatment of anti-VEGF injection. No severe adverse event was noted relevant to the therapy. Conclusion: Intravitreal injection of conbercept can effectively reduce the CMT and improve the BCVA in chronic CSC in a short term of 6 months. Keywords: Chronic central serous chorioretinopathy, Conbercept, Best-corrected visual acuity, Central macular thickness.


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