Subthreshold Micropulse Laser (577 nm) Therapy with an Individual Approach for Power Titration in Patients with Chronic Central Serous Chorioretinopathy (Pilot Study).

Abstract

Purpose: To study the safety and effectiveness of subthreshold micropulse (SML) 577 nm laser therapy with an individual power titration in treating patients with chronic central serous chorioretinopathy (CSC).

Methods: The study was a prospective, single-centre observation of 30 patients (30 eyes) with chronic CSC. All patients with chronic CSC were treated with a 577 nm micropulse laser. Individual power parameters for each patient were titrated in a micropulse mode. The primary outcome measure was best-corrected visual acuity (BCVA) at 6-month follow-up. The secondary outcome measures were as follows: central retinal thickness (CRT) and maximum subretinal fluid height (SRFH) according to optical coherence tomography, number of laser sessions, and treatment safety at 6-month follow-up.

Results: Before treatment, the mean BCVA was 0.35 ± 0.16, the mean CRT was 285 ± 76 µm, and the mean SRFH was 311 ± 85 µm. Six months after 577 nm SML therapy, there was a statistically significant increase in the mean BCVA with the maximum correction to 0.45 ± 0.15 (p = 0.001). The mean CRT and SRFH decreased significantly to 236 ± 45 μm (p = 0.003) and 45 ± 25 μm (p = 0.001), respectively. At the end of the follow-up, complete resorption of the subretinal fluid was noted in 50% (15 eyes), and in 43% (13 eyes), a decrease in the SRFH was observed. During the entire observation period, 25 patients underwent 1 session of 577 nm SML therapy, 2 patients underwent 2 sessions, and 3 patients underwent the intervention three times.

Conclusion: SML 577 nm therapy with individual selection of laser power in a micropulse mode is a safe and effective method of treating patients with chronic CSC. Further studies are needed to test the long-term safety and efficacy of 577 nm SML therapy with individual power settings in chronic CSC.