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. 2021 Jul 16:8:682264.
doi: 10.3389/fmed.2021.682264. eCollection 2021.

Subthreshold Micropulse Laser vs. Conventional Laser for Central Serous Chorioretinopathy: A Randomized Controlled Clinical Trial

Lijun Zhou  1 , Kunbei Lai  1 , Ling Jin  1 , Chuangxin Huang  1 , Fabao Xu  1 , Yajun Gong  1 , Longhui Li  1 , Zhe Zhu  2 , Lin Lu  1 , Chenjin Jin  1
Affiliations

Subthreshold Micropulse Laser vs. Conventional Laser for Central Serous Chorioretinopathy: A Randomized Controlled Clinical Trial

Lijun Zhou et al. Front Med (Lausanne). .

Abstract

Purpose: To investigate the effectiveness and safety of 577-nm subthreshold micropulse laser (SML) on acute central serous chorioretinopathy (CSC). Methods: One hundred and ten patients with acute CSC were randomized to receive SML or 577-nm conventional laser (CL) treatment. Optical coherence tomography and best-corrected visual acuity (BCVA) were performed before and after treatment. Results: At 3 months, the complete resolution of subretinal fluid (SRF) in 577-nm SML group (72.7%) was lower than that in CL group (89.1%) (Unadjusted RR, 0.82; P = 0.029), but it was 85.5 vs. 92.7% at 6 months (unadjusted RR, 0.92; P = 0.221). The mean LogMAR BCVA significantly improved, and the mean central foveal thickness (CFT) significantly decreased in the SML group and CL group (all P < 0.001) at 6 months. But there was no statistical difference between the two groups (all P > 0.05). In the SML group, obvious retinal pigment epithelium (RPE) damage was shown only in 3.64% at 1 month but 92.7% in the CL group (P < 0.001). Conclusions: Although 577-nm SML has a lower complete absorption of SRF compared with 577-nm CL for acute CSC at 3 months, it is similarly effective as 577-nm CL on improving retinal anatomy and function at 6 months. Importantly, 577-nm SML causes less damage to the retina.

Keywords: central foveal thickness; central serous chorioretinopathy; conventional laser photocoagulation; subretinal fluid; subthreshold micropulse laser.

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Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

Figure 1
Figure 1
Study design flow chart.
Figure 2
Figure 2
The change of mean LogMAR-BCVA. The BCVA of all patients showed a statistically significant improvement at each visit compared with the baseline in each group (p < 0.05). Whereas, there was no significant difference between the 577-nm SML group and the 577-nm CL group (p > 0.05). LogMAR, logarithm of the minimum angle of resolution; BCVA, best-corrected visual acuity. SML, subthreshold micropulse laser. CL, conventional laser.
Figure 3
Figure 3
The change of mean CFT during baseline and visits. CFT showed a statistically significant reduction at each visit compared with the baseline in each group (p < 0.05). Whereas, there was no significant difference between 577-nm SML group and 577-nm CL group (p > 0.05). CFT, central foveal thickness. SML, subthreshold micropulse laser. CL, conventional laser.
Figure 4
Figure 4
The comparison of eyes with RPE change on FAF imaging at 1 month after treatments in the 577-nm SML group and 577-nm CL group. Error bars represent standard errors of the mean. SML, subthreshold micropulse laser. CL, conventional laser. RPE, retinal pigment epithelium. FAF, fundus autofluorescence. *P < 0.05.
See this image and copyright information in PMC

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