577 nm subthreshold micropulse laser treatment for acute central serous chorioretinopathy: a comparative study

Abstract

Background: To assess the efficacy of 577 nm subthreshold micropulse laser (SML) treatment for acute central serous chorioretinopathy (CSC).

Methods: This retrospective comparative case-series included 34 eyes of 34 patients with acute CSC who received either 577 nm SML treatment (SML group, n = 16 eyes) or were only monitored (observation group, n = 18 eyes). Acute CSC was defined as disease course < 3 months. Eyes with any history of treatment in the past were excluded. Data were collected over a period of 6 months. The best corrected visual acuity (BCVA), central macular thickness (CMT), and subfoveal choroidal thickness (SFCT) were observed.

Results: SML group showed significantly greater improvement in the BCVA (logMAR) compared to observation group at 1 month (0.20 ± 0.10 vs 0.30 ± 0.12, P < 0.01), 3 months (0.13 ± 0.06 vs 0.21 ± 0.06, P < 0.01) and 6 months (0.01 ± 0.06 vs 0.09 ± 0.66, P < 0.01). The CMT reduction was significantly greater in the SML group at 1 month (337.19 ± 62.96 µm vs 395.11 ± 91.30 µm, P < 0.05), 3 months (312.94 ± 49.50 µm vs 364.50 ± 70.30 µm, P < 0.05) and 6 months (291.38 ± 26.46 µm vs 348.56 ± 54.65 µm, P < 0.05). In the SML group, the SFCT did not show a significant decrease at 1 month (468.88 ± 42.19 µm, P > 0.05) but showed a significant reduction at 3 months (451.75 ± 39.36 µm, P < 0.05) and 6 months (450.50 ± 34.24 µm, P < 0.05) from baseline (489.94 ± 45.86 µm). In the observation group, there was no significant change in SFCF during follow-up. No adverse events occurred in the SML group.

Conclusions: Although some patients with acute CSC show spontaneous healing, timely intervention with 577 nm SML can shorten the disease course, improve visual acuity, and reduce the risk of chronic transformation without adverse events.

Keywords: 577 nm subthreshold micropulse laser; Acute central serous chorioretinopathy; Central macular thickness; Subfoveal choroidal thickness.

Fig.1

Changes in the mean best corrected visual acuity (BCVA) from baseline to 6 months in the two groups. LogMAR, logarithm of the minimum angle of resolution; SML, subthreshold micropulse laser

Fig.2

Changes in the mean central macular thickness from baseline to 6 months in the two groups. SML, subthreshold micropulse laser

Fig.3

Changes in the mean subfoveal choroidal thickness from baseline to 6 months in the two groups. SML, subthreshold micropulse laser

Fig.4

Fundus fluorescein angiography (FFA) and optical coherence tomography (OCT) of a patient with acute CSC at baseline, 1 month, and 3 months. A) A hot spot of leakage is visible on FFA at baseline. B and C show subretinal fluid (SRF) on OCT at baseline and 1 month after SML treatment, respectively. D) The SRF has completely resolved 3 months after SML treatment; no signs of laser-induced damage are seen