Subthreshold laser therapy with a standardized macular treatment pattern in chronic central serous chorioretinopathy.

Autor: Schworm B; Department of Ophthalmology, Ludwig-Maximilians-University Munich, Mathildenstrasse 8, 80336, Munich, Germany. benedikt.schworm@med.uni-muenchen.de., Siedlecki J; Department of Ophthalmology, Ludwig-Maximilians-University Munich, Mathildenstrasse 8, 80336, Munich, Germany., Keidel LF; Department of Ophthalmology, Ludwig-Maximilians-University Munich, Mathildenstrasse 8, 80336, Munich, Germany., Herold TR; Department of Ophthalmology, Ludwig-Maximilians-University Munich, Mathildenstrasse 8, 80336, Munich, Germany., Luft N; Department of Ophthalmology, Ludwig-Maximilians-University Munich, Mathildenstrasse 8, 80336, Munich, Germany., Priglinger SG; Department of Ophthalmology, Ludwig-Maximilians-University Munich, Mathildenstrasse 8, 80336, Munich, Germany.
Jazyk: angličtina
Zdroj: Graefe's archive for clinical and experimental ophthalmology = Albrecht von Graefes Archiv fur klinische und experimentelle Ophthalmologie [Graefes Arch Clin Exp Ophthalmol] 2021 Nov; Vol. 259 (11), pp. 3271-3281. Date of Electronic Publication: 2021 Jun 10.
DOI: 10.1007/s00417-021-05256-3
Abstrakt: Purpose: There is an ongoing controversial debate about the effectiveness of laser treatments in chronic central serous chorioretinopathy (cCSC). We performed a prospective non-randomized interventional study to learn about the effects of a subthreshold laser treatment (Topcon Endpoint Management™, Topcon Healthcare Inc., Tokyo, Japan) in patients with cCSC.
Methods: Patients with cCSC and a minimum symptom duration of 4 months were included and treated with a standardized laser pattern covering the macular area. Retreatment was performed every 3 months if persistent subretinal fluid was observed. The primary endpoint was resolution of subretinal fluid at 6 months. Further outcome parameters included best corrected visual acuity, microperimetry, central macular and subfoveal choroidal thickness.
Results: A total of 42 eyes of 39 patients were included. Mean patient age was 48 ± 10.6 years (range 25-67). Mean symptomatic time before inclusion into the study was 134 ± 133.4 weeks (16-518). Before inclusion, 78.6% of the patients had failed to resolve subretinal fluid under mineralocorticoid receptor antagonists and 14.3% had a recurrence after half-dose photodynamic therapy. Complete resolution of subretinal fluid was observed in 42.9% at 6 months and in 53.8% at 12 months after baseline. Central retinal thickness decreased from 398 ± 135 µm to 291 ± 68 µm (p < 0.001), subfoveal choroidal thickness changed slightly (430 ± 116 µm to 419 ± 113 µm, p = 0.026), microperimetry-derived macular function improved by 19.1 ± 4.7 dB to 21.3 ± 4.8 dB (p = 0.008) and mean BCVA improved by 4.9 ± 8.6 ETDRS letters (p < 0.001).
Conclusion: The results show that the investigated laser treatment is effective in reducing subretinal fluid and leads to an improvement of functional parameters.
(© 2021. The Author(s).)
Databáze: MEDLINE
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