4.4 Article

The efficacy of subthreshold micropulse yellow laser (577 nm) in chronic central serous chorioretinopathy

Journal

LASERS IN MEDICAL SCIENCE
Volume 36, Issue 5, Pages 981-988

Publisher

SPRINGER LONDON LTD
DOI: 10.1007/s10103-020-03129-5

Keywords

Chronic central serous chorioretinopathy; Subthreshold laser; Micropulse laser; Prognostic factors

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Subthreshold micropulse laser therapy is effective in treating chronic central serous chorioretinopathy, improving visual acuity and reducing retinal damage. Visual acuity is closely associated with the duration of disease and changes in outer nuclear layer thickness.
Central serous chorioretinopathy (CSC) is a disease characterized by a well-defined serous detachment of the neurosensory retina. Therapeutic options in chronic cases are limited, and side effects can result in a limited response. The aim of this article is to assess the efficacy of subthreshold micropulse laser therapy in patients with chronic central serous chorioretinopathy. The study included 20 eyes of 19 patients who had a history of chronic or chronic recurrent CSC and who underwent subthreshold micropulse laser therapy between January 2015 and June 2018. Twenty eyes of 19 patients with a mean age of 48.9 +/- 9.40 years were included. The mean visual acuity was 0.24 +/- 0.28 logMAR before laser, 0.19 +/- 0.25 logMAR 3 months after laser, and 0.18 +/- 0.27 logMAR after 6 months. A statistically significant difference was determined in terms of visual acuity before and after treatment (p= 0.0001). The mean central retinal thickness was 308.10 +/- 95.25 mu m before laser, 233.65 +/- 81.17 mu m 3 months after laser, and 203.88 +/- 72.79 mu m at 6 months. A statistically significant relationship was present between visual acuity and the duration of disease (p= 0.001), between visual acuity and the outer nuclear layer thickness (p= 0.005), and between the outer nuclear layer thickness and the duration of disease in chronic cases (p= 0.008). There was no evidence of retinal pigment epithelium or retinal damage on optical coherence tomography or fundus autofluorescence secondary to subthreshold micropulse laser therapy. Visual acuity appears to be more associated with the duration of disease and with changes in the outer nuclear layer thickness in chronic CSC. Subthreshold micropulse laser therapy seems to be effective at treating chronic CSC, while it increases success during early period of the disease before the development of permanent retinal damage.

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