Short-duration multiple-session subthreshold micropulse yellow laser (577 nm) for chronic central serous chorioretinopathy: results at 3 years

• Published in: Eye (London) 2019-05, Vol.33 (5), p.819-825
• Main Authors: Kim, Yang Jae, Kim, Si Yeol, Ha, Seungmin, Moon, Daruchi, Seong, San, Kwon, Oh Woong, Park, Han Sang
• Format: Article
• Language: English
• Subjects: 692/308/409; 692/699/3161/3175; Acuity; Adult; Central Serous Chorioretinopathy - physiopathology; Central Serous Chorioretinopathy - surgery; Chronic Disease; Epithelium; Eye; Female; Follow-Up Studies; Humans; Laboratory Medicine; Laser Coagulation - methods; Lasers; Lasers, Semiconductor; Male; Medicine; Medicine & Public Health; Middle Aged; Ophthalmology; Pharmaceutical Sciences/Technology; Retina; Retinal pigment epithelium; Retrospective Studies; Subretinal Fluid; Surgery; Surgical Oncology; Time Factors; Titration; Treatment Outcome; Visual Acuity - physiology
• ISSN: 0950-222X; 1476-5454
• DOI: 10.1038/s41433-018-0309-7

Objectives To review the 3-year follow-up results of subthreshold micropulse yellow laser (SMYL) delivered by a short-duration multiple-session method for treatment of chronic central serous chorioretinopathy (CSC). Methods A total of 27 eyes from 27 patients with chronic CSC available for 3 years of follow-up were enrolled in this retrospective and interventional study. Patients were treated with 577-nm SMYL photocoagulation at a 15% duty cycle over multiple sessions, with low power ranging from 200 to 400 mW that was increased in 100 mW increments according to resolution of subretinal fluid at monthly follow-up. Laser titration was not performed. A treatment duration of 20 ms rather than the conventional duration (100–300 ms) was applied over the area of retinal pigment epithelium leakage and all areas of serous retinal detachment, including the fovea. Results The mean follow-up period was 3.7 ± 0.8 years (range, 3–6 years). A total of 22 out of 27 eyes (81.5%) including six cases of recurrence during the follow-up period exhibited complete resolution of subretinal detachment at final follow-up, whereas only five eyes (15.5%) had either a partial or null response to SMYL treatment. The baseline best-corrected visual acuity was 0.26 ± 0.24 logarithm of the minimum angle of resolution (logMAR), which was improved to 0.08 ± 0.15 logMAR at 1-year ( p  = 0.005) and 3-year ( p  = 0.01) follow-up. The central macular thickness at baseline was 389.6 ± 103.4 μm, which was changed to 197.2 ± 40.0 μm ( p