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Selective retina therapy with automatic real-time feedback-controlled dosimetry for chronic central serous
Young Gun Park1, Seungbum Kang2, Minhee Kim1
1Department of Ophthalmology and Visual Science, Yeouido St. Mary's Hospital, Catholic University of Korea, 10,63-ro. 62, Yeongdeungpo-gu, Seoul, 07345, Republic of Korea.
Purpose:
To evaluate the safety and efficacy of selective retina therapy (SRT) with real-time feedback-controlled dosimetry (RFD) in the treatment of chronic central serous chorioretinopathy (CSC).
Methods:
In this retrospective case series study, 50 eyes of 49 patients with chronic CSC demonstrating focal or diffuse foveal leakages on fundus fluorescein angiography (FFA) were included. Following evaluation of test spots at temporal arcades, SRT (wavelength 527 nm, pulse repetition rate 100 Hz, pulse energy ramp with maximal 15 pulses) with retinal spot diameter of 200 μm was applied to the areas of each leakage observed on fluorescein angiography. Changes in mean best corrected visual acuity (BCVA), maximum macular thickness (MMT), subretinal fluid (SRF) height, and subfoveal choroidal thickness (SCT) were evaluated at 1, 2 and 3 months after treatment. RFD was used for adjusting the pulse energy. Eyes received a mean of 21.1 ± 18.1 treatment spots with a range of energies between 50uJ and 200uJ per pulse.
Results:
Subretinal fluid (SRF) was completely resolved in 74% (37/50 eyes) at month 3. Mean BCVA (LogMAR) was improved from 0.44 ± 0.29 at baseline to 0.37 ± 0.32 at month 3 (p = 0.001). MMT was decreased from 335.0 ± 99.8 μm at baseline to 236.4 ± 66.4 μm after 3 months (p < 0.001). SRF height was decreased from 168.0 ± 77.3 μm at baseline to 29.0 ± 57.3 μm after 3 months (p < 0.001). However, the changes in SCT were not statistically significant (p = 0.48).
Conclusions:
SRT treatment with RFD showed favorable visual and anatomical outcomes in patients with chronic CSC.