Purpose: To assess treatment with a 577-nm subthreshold micropulse laser (SML) in patients with chronic central serous chorioretinopathy (cCSC). Methods: This retrospective study included 38 patients treated with a 577-nm SML (Supra Scan; Quantel Medical) for cCSC. We included a subgroup of 18 patients with persistent subretinal fluid (SRF) after photodynamic therapy (PDT). Assessment included visual acuity (VA), central retinal thickness (CRT) and resolution of SRF. Results: At the last follow-up (mean 5 months), 74% of patients responded to therapy. The CRT decreased after treatment (mean CRT -115 µm, p < 0.001) and VA improved (mean logMAR -0.06, p = 0.039). No laser burns were detected with any imaging modality. In the subgroup of patients resistant to PDT, 61% of patients responded to therapy with a decrease in CRT (mean CRT -75 µm, p = 0.019). Conclusions: The 577-nm SML is an effective treatment for cCSC even in patients without sufficient improvement after PDT.

Keywords:
Central serous chorioretinopathy, Subthreshold micropulse laser, Photodynamic therapy
1.
Gass J: Pathogenesis of disciform detachment of the neuroepithelium. II. Idiopathic central serous choroidopathy. Am J Ophthalmol 1967;63:587-615.
2.
Liew G, Quin G, Gillies M, Fraser‐Bell S: Central serous chorioretinopathy: a review of epidemiology and pathophysiology. Clin Experiment Ophthalmol 2013;41:201-214.
3.
Gemenetzi M, De Salvo G, Lotery A: Central serous chorioretinopathy: an update on pathogenesis and treatment. Eye 2010;24:1743-1756.
4.
Klein ML, Van Buskirk EM, Friedman E, Gragoudas E, Chandra S: Experience with nontreatment of central serous choroidopathy. Arch Ophthalmol 1974;91:247-250.
5.
Gilbert CM, Owens SL, Smith PD, Fine SL: Long-term follow-up of central serous chorioretinopathy. Br J Ophthalmol 1984;68:815-820.
6.
Ficker L, Vafidis G, While A, Leaver P: Long-term follow-up of a prospective trial of argon laser photocoagulation in the treatment of central serous retinopathy. Br J Ophthalmol 1988;72:829-834.
7.
Fok AC, Chan PP, Lam DS, Lai TY: Risk factors for recurrence of serous macular detachment in untreated patients with central serous chorioretinopathy. Ophthalmic Res 2011;46:160-163.
8.
Leaver P, Williams C: Argon laser photocoagulation in the treatment of central serous retinopathy. Br J Ophthalmol 1979;63:674-677.
9.
Schatz H, Yannuzzi LA, Gitter KA: Subretinal neovascularization following argon laser photocoagulation treatment for central serous chorioretinopathy: complication or misdiagnosis? Retina 2012;32(suppl 1):OP893-OP906.
10.
Khosla P, Rana S, Tewari H, Azad R, Talwar D: Evaluation of visual function following argon laser photocoagulation in central serous retinopathy. Ophthalmic Surg Lasers 1997;28:693-697.
11.
Colucciello M: Choroidal neovascularization complicating photodynamic therapy for central serous retinopathy. Retina 2006;26:239-242.
12.
Lai TY, Chan W-M, Lam DS: Transient reduction in retinal function revealed by multifocal electroretinogram after photodynamic therapy. Am J Ophthalmol 2004;137:826-833.
13.
Fujita K, Imamura Y, Shinoda K, Matsumoto CS, Mizutani Y, Hashizume K, Mizota A, Yuzawa M: One-year outcomes with half-dose verteporfin photodynamic therapy for chronic central serous chorioretinopathy. Ophthalmology 2015;122:555-561.
14.
Lim JI, Glassman AR, Aiello LP, Chakravarthy U, Flaxel CJ, Spaide RF; Macula Society CSC Collaborative Study Group, Research and Education Committee and Website Committee: Collaborative retrospective macula society study of photodynamic therapy for chronic central serous chorioretinopathy. Ophthalmology 2014;121:1073-1078.
15.
Tseng C-C, Chen S-N: Long-term efficacy of half-dose photodynamic therapy on chronic central serous chorioretinopathy. Br J Ophthalmol 2015;99:1070-1077.
16.
Lanzetta P, Dorin G, Pirracchio A, Bandello F: Theoretical bases of non-ophthalmoscopically visible endpoint photocoagulation. Semin Ophthalmol 2001;16:8-11.
17.
Chen S-N, Hwang J-F, Tseng L-F, Lin C-J: Subthreshold diode micropulse photocoagulation for the treatment of chronic central serous chorioretinopathy with juxtafoveal leakage. Ophthalmology 2008;115:2229-2234.
18.
Bandello F, Lanzetta P, Furlan F, Polito A: Nonvisible subthreshold micropulse diode laser treatment of idiopathic central serous chorioretinopathy. A pilot study. Invest Ophthalmol Vis Sci 2003;44:4858.
19.
Gupta B, Elagouz M, McHugh D, Chong V, Sivaprasad S: Micropulse diode laser photocoagulation for central serous chorio-retinopathy. Clin Experiment Ophthalmol 2009;37:801-805.
20.
Lanzetta P, Furlan F, Morgante L, Veritti D, Bandello F: Nonvisible subthreshold micropulse diode laser (810 nm) treatment of central serous chorioretinopathy. A pilot study. Eur J Ophthalmol 2007;18:934-940.
21.
de Jong EK, Breukink MB, Schellevis RL, Bakker B, Mohr JK, Fauser S, Keunen JE, Hoyng CB, den Hollander AI, Boon CJ: Chronic central serous chorioretinopathy is associated with genetic variants implicated in age-related macular degeneration. Ophthalmology 2015;122:562-570.
22.
Sivaprasad S, Elagouz M, McHugh D, Shona O, Dorin G: Micropulsed diode laser therapy: evolution and clinical applications. Surv Ophthalmol 2010;55:516-530.
23.
Wang MS, Sander B, Larsen M: Retinal atrophy in idiopathic central serous chorioretinopathy. Am J Ophthalmol 2002;133:787-793.
24.
Lavinsky D, Palanker D: Nondamaging photothermal therapy for the retina: initial clinical experience with chronic central serous retinopathy. Retina 2015;35:213-222.
25.
Yadav N, Jayadev C, Mohan A, Vijayan P, Battu R, Dabir S, Shetty B, Shetty R: Subthreshold micropulse yellow laser (577 nm) in chronic central serous chorioretinopathy: safety profile and treatment outcome. Eye (Lond) 2015;29:258-264.
26.
Yu AK, Merrill KD, Truong SN, Forward KM, Morse LS, Telander DG: The comparative histologic effects of subthreshold 532- and 810-nm diode micropulse laser on the retina. Invest Ophthalmol Vis Sci 2013;54:2216-2224.
© 2015 S. Karger AG, Basel
2015
Copyright / Drug Dosage / Disclaimer
Copyright: All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher.
Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in government regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug.
Disclaimer: The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publishers and the editor(s). The appearance of advertisements or/and product references in the publication is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements.
You do not currently have access to this content.