Selective micropulse individual retinal therapy in the navigation- guided treatment for central serous chorioretinopathy with parameter selection by preliminary testing

Abstract

Aim: to evaluate the outcomes of selective micropulse individual retinal therapy (SMIRT) in navigation-guided treatment for central serous chorioretinopathy (CSCR) by selecting parameters by preliminary testing. Patients and Methods: 61 patients (61 eyes) aged 36–58 with acute CSCR and transparent media were enrolled. The patients were divided into two groups. In the study group (31 eyes), CSCR treatment was performed using SMIRT technology and Laser system. Micropulse mode was applied. According to the computer simulation, this mode implies selective destruction of the retinal pigment epithelium with minimal damage to the neurosensory retina and choroid. Parameters were customized for each patient by preliminary testing and evaluation of the results by short-wavelength fundus autofluorescence (488 nm). Laser spots were applied close to each other to completely cover the leakage points revealed by fluorescein angiography. Control group patients (30 eyes) did not receive laser treatment. Follow-up examinations were performed 1, 3, 6, and 12 months after enrollment. Results: after one year, complete resorption of subretinal fluid was reported in all eyes in the study group and 10 eyes (33.3%) in the control group. In the study group, the best-corrected visual acuity (BCVA) increased from 0.85±0.02 to 0.98±0.02 (p<10-8), while central photosensitivity increased from 24.34±0.33 to 29.15±0.17 dB (p<6×10-6). In the control group, BCVA decreased from 0.84±0.02 to 0.77±0.03, while photosensitivity slightly increased from 25.09±0.32 to 25.32±0.72 dB. Conclusion: navigation-guided treatment for CSCR using the SMIRT technology with selecting parameters by preliminary testing has demonstrated high efficacy and safety. This tool can be used when leakage points are located in the fovea. KEYWORDS: selective micropulse individual retinal therapy (SMIRT), central serous chorioretinopathy, micropulse, navigation, customized approach. FOR CITATION: Volodin P.L., Ivanova E.V. Selective micropulse individual retinal therapy in the navigation-guided treatment for central serous chorioretinopathy with parameter selection by preliminary testing. Russian Journal of Clinical Ophthalmology. 2023;23(3):112–118 (in Russ.). DOI: 10.32364/2311-7729-2023-23-3-1.