Ayako Yasui1, Manabu Yamamoto2, Kumiko Hirayama1, Kunihiko Shiraki1, Dirk Theisen-Kunde3, Ralf Brinkmann3, Yoko Miura3,4,5, Takeya Kohno1. 1. Department of Ophthalmology and Visual Sciences, Osaka City University Graduate School of Medicine, 1-4-3 Asahi-machi, Abeno-ku, 545-8585, Osaka, Japan. 2. Department of Ophthalmology and Visual Sciences, Osaka City University Graduate School of Medicine, 1-4-3 Asahi-machi, Abeno-ku, 545-8585, Osaka, Japan. shidai.srtmaia@gmail.com. 3. Medical Laser Center Lübeck GmbH, Lübeck, Germany. 4. Institute of Biomedical Optics, University of Lübeck, Lübeck, Germany. 5. Department of Ophthalmology, University of Lübeck, Lübeck, Germany.
Abstract
PURPOSE: To assess retinal sensitivity after selective retina therapy (SRT) in patients with central serous chorioretinopathy (CSCR). METHODS: Seventeen eyes of 17 patients with CSCR lasting longer than 3 months were treated with SRT (wavelength 527 nm Nd: YLF laser, 50-150 μJ/pulse, spot diameter 200 μm). Measurement of best-corrected visual acuity (BCVA), optical coherence tomography, fluorescence angiography, and microperimetry (MAIA™) were conducted before, and 1 and 3 months after treatment. Microperimetry was performed in the central 10° of the macula, and at the test spots applied near the vascular arcade for energy titration. In addition to the treatment effect, all test irradiation spots were thoroughly analyzed with regard to their sensitivity changes. RESULTS: The mean logMAR BCVA had improved from 0.06 to 0.02 after 1 month (p = 0.11) and to 0.03 after 3 months (p = 0.003). Eleven out of 17 eyes (64.7%) showed complete resolution of subretinal fluid after 3 months. Retinal sensitivity in the central 10° increased after 1 month (median: 25.9 dB) and 3 months (26.6 dB) as compared with that before treatment (23.0 dB) (p < 0.001). Analysis of the test spots revealed a slight decrease in retinal sensitivity after 1 month (ΔdB = -0.5 ± 2.1, p = 0.006), while there was no significant difference from baseline after 3 months (ΔdB = -0.3 ± 2.2, p = 0.09). No correlation was found between laser energy and the change in focal retinal sensitivity. CONCLUSIONS: Results suggest that SRT is a safe and effective treatment for persistent CSCR and does not leave permanent scotoma regardless of irradiation energy in the therapeutic range.
PURPOSE: To assess retinal sensitivity after selective retina therapy (SRT) in patients with central serous chorioretinopathy (CSCR). METHODS: Seventeen eyes of 17 patients with CSCR lasting longer than 3 months were treated with SRT (wavelength 527 nm Nd: YLF laser, 50-150 μJ/pulse, spot diameter 200 μm). Measurement of best-corrected visual acuity (BCVA), optical coherence tomography, fluorescence angiography, and microperimetry (MAIA™) were conducted before, and 1 and 3 months after treatment. Microperimetry was performed in the central 10° of the macula, and at the test spots applied near the vascular arcade for energy titration. In addition to the treatment effect, all test irradiation spots were thoroughly analyzed with regard to their sensitivity changes. RESULTS: The mean logMAR BCVA had improved from 0.06 to 0.02 after 1 month (p = 0.11) and to 0.03 after 3 months (p = 0.003). Eleven out of 17 eyes (64.7%) showed complete resolution of subretinal fluid after 3 months. Retinal sensitivity in the central 10° increased after 1 month (median: 25.9 dB) and 3 months (26.6 dB) as compared with that before treatment (23.0 dB) (p < 0.001). Analysis of the test spots revealed a slight decrease in retinal sensitivity after 1 month (ΔdB = -0.5 ± 2.1, p = 0.006), while there was no significant difference from baseline after 3 months (ΔdB = -0.3 ± 2.2, p = 0.09). No correlation was found between laser energy and the change in focal retinal sensitivity. CONCLUSIONS: Results suggest that SRT is a safe and effective treatment for persistent CSCR and does not leave permanent scotoma regardless of irradiation energy in the therapeutic range.
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