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Selective Retina Therapy in Patients With Chronic Central Serous Chorioretinopathy

View Article: PubMed Central - PubMed

ABSTRACT

We evaluated visual outcomes, changes of maximum macular thickness (MMT) and subretinal fluid (SRF), and safety in patients with chronic central serous chorioretinopathy (CSC) after treatment with selective retina therapy (SRT). Retrospective cohort study of patients with chronic CSC presenting to a university-based hospital from January 2014 through January 2015 was conducted. A total of 12 eyes of 12 patients with chronic CSC lasting for at least 3 months was recruited. The follow-up period ranged from 3 to 12 months. Following evaluation of test spots at temporal arcades, SRT (Q-switched neodymium-doped yttrium lithium fluoride [Nd:YLF] laser; wavelength, 527 nm, pulse duration, 1.7 microsececond) was applied to the surrounding areas of leakage observed on fluorescein angiogram and/or pigment epithelial detachment (PED). Changes in best-correct visual acuity (BCVA), MMT, and SRF and macular sensitivity (MS) by microperimetry (MP) were evaluated. Eyes received treatment in a mean of 3.83 spots at the pulse energy of 65 to 90 μJ. Mean BCVA (logMAR) improved from 0.23 ± 0.12 at baseline to 0.14 ± 0.13 at 3 months. MMT decreased from 341.4 ± 85.5 μm at baseline to 236.0 ± 57.9 μm at 3 months. SRF completely resolved in 75% (9 eyes) at 3 months. Large PEDs (2 eyes) were flattened at 3 months. Retreatment was performed in 4 eyes. MP showed no evidence of scotoma around SRT-treated lesions. SRT treatment targeting the surrounding area of leakage point showed favorable visual and structural outcomes in chronic CSC patients without the risk of scotoma.

No MeSH data available.


Related in: MedlinePlus

Microperimetry (MP) data were obtained after the complete resolution of subretinal fluid in selective retina therapy (SRT)-treated 12 patients. In all cases, there was no detectable scotoma in any of the SRT-treated lesions. Red circles indicate the SRT-irradiated points. White circles indicate leak points shown in fundus fluorescein angiography.
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Figure 8: Microperimetry (MP) data were obtained after the complete resolution of subretinal fluid in selective retina therapy (SRT)-treated 12 patients. In all cases, there was no detectable scotoma in any of the SRT-treated lesions. Red circles indicate the SRT-irradiated points. White circles indicate leak points shown in fundus fluorescein angiography.

Mentions: The mean number of applied SRT spots was 3.83. The range of pulse energy used for each treatment was between 65 and 90 μJ. All SRT laser spots were undetectable by color fundus photography and FFA 3 months after SRT treatment. Although SRT spots were invisible during the irradiation, some barely visible SRT spots were observed on fundus photography several minutes after SRT. However, these lesions faded and completely disappeared on fundus photography during follow-up. The autofluorescence of SRT spots was transiently increased after SRT treatment. The increased autofluorescence faded gradually during 3-month follow-up (Figure 7C and D). FFA was performed in order to confirm the success of laser treatment and ensure that sufficient energy was used in the selective damage of the RPE. The SRT spots were visible on FFA at 1 week, indicating some damage to the RPE, but all SRT laser spots had disappeared on FFA at 2 or 3 months, demonstrating recovery of the damaged area. Mean MS was 27.1 ± 0.95 dB after a resolution of SRF. The range of MS of SRT-treated lesions on MP was from 21 dB (the lowest) to 29 dB (the highest). The maximum difference of MS between SRT-treated lesion and untreated adjacent region was only 3 dB. Therefore, SRT did not cause any scotoma (Figure 8). In addition, no evidence of photoreceptor damage was observed on OCT in all SRT-treated regions.


Selective Retina Therapy in Patients With Chronic Central Serous Chorioretinopathy
Microperimetry (MP) data were obtained after the complete resolution of subretinal fluid in selective retina therapy (SRT)-treated 12 patients. In all cases, there was no detectable scotoma in any of the SRT-treated lesions. Red circles indicate the SRT-irradiated points. White circles indicate leak points shown in fundus fluorescein angiography.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4998269&req=5

Figure 8: Microperimetry (MP) data were obtained after the complete resolution of subretinal fluid in selective retina therapy (SRT)-treated 12 patients. In all cases, there was no detectable scotoma in any of the SRT-treated lesions. Red circles indicate the SRT-irradiated points. White circles indicate leak points shown in fundus fluorescein angiography.
Mentions: The mean number of applied SRT spots was 3.83. The range of pulse energy used for each treatment was between 65 and 90 μJ. All SRT laser spots were undetectable by color fundus photography and FFA 3 months after SRT treatment. Although SRT spots were invisible during the irradiation, some barely visible SRT spots were observed on fundus photography several minutes after SRT. However, these lesions faded and completely disappeared on fundus photography during follow-up. The autofluorescence of SRT spots was transiently increased after SRT treatment. The increased autofluorescence faded gradually during 3-month follow-up (Figure 7C and D). FFA was performed in order to confirm the success of laser treatment and ensure that sufficient energy was used in the selective damage of the RPE. The SRT spots were visible on FFA at 1 week, indicating some damage to the RPE, but all SRT laser spots had disappeared on FFA at 2 or 3 months, demonstrating recovery of the damaged area. Mean MS was 27.1 ± 0.95 dB after a resolution of SRF. The range of MS of SRT-treated lesions on MP was from 21 dB (the lowest) to 29 dB (the highest). The maximum difference of MS between SRT-treated lesion and untreated adjacent region was only 3 dB. Therefore, SRT did not cause any scotoma (Figure 8). In addition, no evidence of photoreceptor damage was observed on OCT in all SRT-treated regions.

View Article: PubMed Central - PubMed

ABSTRACT

We evaluated visual outcomes, changes of maximum macular thickness (MMT) and subretinal fluid (SRF), and safety in patients with chronic central serous chorioretinopathy (CSC) after treatment with selective retina therapy (SRT). Retrospective cohort study of patients with chronic CSC presenting to a university-based hospital from January 2014 through January 2015 was conducted. A total of 12 eyes of 12 patients with chronic CSC lasting for at least 3 months was recruited. The follow-up period ranged from 3 to 12 months. Following evaluation of test spots at temporal arcades, SRT (Q-switched neodymium-doped yttrium lithium fluoride [Nd:YLF] laser; wavelength, 527 nm, pulse duration, 1.7 microsececond) was applied to the surrounding areas of leakage observed on fluorescein angiogram and/or pigment epithelial detachment (PED). Changes in best-correct visual acuity (BCVA), MMT, and SRF and macular sensitivity (MS) by microperimetry (MP) were evaluated. Eyes received treatment in a mean of 3.83 spots at the pulse energy of 65 to 90 μJ. Mean BCVA (logMAR) improved from 0.23 ± 0.12 at baseline to 0.14 ± 0.13 at 3 months. MMT decreased from 341.4 ± 85.5 μm at baseline to 236.0 ± 57.9 μm at 3 months. SRF completely resolved in 75% (9 eyes) at 3 months. Large PEDs (2 eyes) were flattened at 3 months. Retreatment was performed in 4 eyes. MP showed no evidence of scotoma around SRT-treated lesions. SRT treatment targeting the surrounding area of leakage point showed favorable visual and structural outcomes in chronic CSC patients without the risk of scotoma.

No MeSH data available.


Related in: MedlinePlus