Comparison of subthreshold micropulse laser (577 nm) treatment and half-dose photodynamic therapy in patients with chronic central serous chorioretinopathy

Eye (Lond). 2016 Oct;30(10):1371-1377. doi: 10.1038/eye.2016.142. Epub 2016 Jul 8.

Abstract

PurposeTo compare the short-term treatment outcome of the 577 nm subthreshold micropulse laser (SML) and half-dose photodynamic therapy (PDT) in patients with chronic central serous chorioretinopathy (cCSC) and persistent subretinal fluid (SRF).MethodsThis retrospective study included 100 eyes of 100 consecutive patients who were treated with the 577 nm SML (Supra Scan, Quantel Medical) (n=42) or half-dose PDT (n=58) for cCSC. The treatment was applied at the leakage sites in the fluorescein and indocyanine green angiography. The treatment success was evaluated 6 weeks after treatment using best-corrected visual acuity, central retinal thickness, and resolution of SRF in spectral domain optical coherence tomography.ResultsPatients showed treatment response more often in the SML group compared with the PDT group (treatment response after SML: 33 eyes (79%), PDT: 34 eyes (59%), P=0.036, χ2 test). The CRT decreased significantly after both treatments (mean CRT before SML: 445±153 μm, after SML: 297±95, P<0.001; mean CRT before PDT: 398±88 μm, after PDT: 322±93 μm, P<0.001, Wilcoxon's signed-rank test). The decrease in CRT was statistically significantly higher in the SML group (decrease in CRT after SML: -148±163 μm, after PDT: -76±104 μm, P=0.041, Mann-Whitney U-test).ConclusionsBoth the half-dose PDT and the 577 nm SML are potent treatments for cCSC with persistent SRF. More patients showed treatment response to the SML treatment and SML leads to a greater decrease in CRT.

Publication types

  • Comparative Study

MeSH terms

  • Adult
  • Aged
  • Capillary Permeability / drug effects
  • Central Serous Chorioretinopathy / drug therapy
  • Central Serous Chorioretinopathy / physiopathology
  • Central Serous Chorioretinopathy / surgery
  • Central Serous Chorioretinopathy / therapy*
  • Chronic Disease
  • Female
  • Fluorescein Angiography
  • Humans
  • Laser Coagulation*
  • Male
  • Middle Aged
  • Photochemotherapy*
  • Photosensitizing Agents / administration & dosage
  • Porphyrins / administration & dosage
  • Retrospective Studies
  • Subretinal Fluid
  • Tomography, Optical Coherence
  • Verteporfin
  • Visual Acuity / physiology

Substances

  • Photosensitizing Agents
  • Porphyrins
  • Verteporfin