Subthreshold micropulse yellow laser (577 nm) in chronic central serous chorioretinopathy: safety profile and treatment outcome

Abstract

Purpose: To assess the safety and efficacy of a single session of subthreshold micropulse (SM) yellow laser (577 nm) in the treatment of chronic central serous chorioretinopathy (CSCR).

Methods: This was a retrospective analysis of 15 eyes of 13 patients with CSCR of >3 months duration who had been treated with SM yellow laser (577 nm). All patients had been treated using multiple spots of laser with a duty cycle of 10% over areas of focal and diffuse leak, as seen on fundus fluorescein angiography (FFA) and indocyanine green angiography (ICGA). Reduction in subretinal fluid height on spectral domain optical coherence tomography (SD-OCT) was used to measure the response to treatment.

Results: The mean follow-up was at 8 weeks (4-19 weeks). All eyes responded to treatment. The mean subretinal fluid height pre and post treatment was 232 and 49 μm, respectively, showing a 79% average reduction (P<0.001) in fluid height. There was no evidence of retinal pigment epithelium or retinal damage on SD-OCT, FFA, or fundus autofluorescence. Median visual improvement was one line on Snellen's visual acuity chart (P=0.015). Microperimetry was performed in eight eyes of which six eyes (75%) showed an improvement in the threshold values post treatment.

Conclusion: SM yellow laser is an effective treatment option for chronic CSCR.

Figures

Figure 1

FFA of a patient showing a well-defined juxtafoveal inkblot pattern of about half a disc diameter is seen and corresponding leakage in ICGA demonstrating a hyperdynamic choroidal circulation with hypofluorescent spots indicating choroidal ischemia. Areas of RPE abnormalities are also noted.

Figure 2

Pre- and post-laser SD-OCT images of a patient showing complete resolution of subretinal fluid.

Figure 3

Microperimetry of a patient showing progressive improvement.