Selective retina therapy in patients with central serous chorioretinopathy.
BACKGROUND
Central serous chorioretinopathy (CSC) is a disease with a localized breakdown of the outer blood-retinal barrier located within the retinal pigment epithelium (RPE) causing subretinal fluid accumulation. Selective retina therapy (SRT) is a new, minimally invasive laser technology that has been designed to selectively target the RPE. SRT spares retinal tissue.


METHODS
Twenty-seven eyes of 27 patients with active CSC were treated with SRT using a pulsed double-Q-switched Nd-YLF prototype laser (lambda=527 nm, t=1.7 micros). At baseline, best-corrected visual acuity was determined and fluorescein angiography and optical coherence tomography were performed. The patients were followed for up to 3 months.


RESULTS
After 4 weeks 85.2% of patients showed complete resolution of subretinal fluid and in 96.3% there was no leakage visible on fluorescein angiography. After 3 months 100% of patients demonstrated no subretinal fluid and 100% of patients had no leakage activity on fluorescein angiography. Visual acuity, 20/40 at baseline, improved to 20/28 after 4 weeks and to 20/20 after 3 months.


CONCLUSIONS
SRT is a safe and effective treatment for active CSC. Especially if the RPE leak is located close to the fovea, SRT is the favoured therapeutic option. We recommend earlier treatment of patients with acute CSC in order to prevent development of chronic changes due to CSC with irreversible anatomical and functional damage. SRT might be considered as a first-line treatment for active CSC.
Elsner
H
H
Department of Ophthalmology, University of Schleswig-Holstein, Campus Kiel, Hegewischstrasse 2, 24105 Kiel, Germany. helsner@ophthalmol.uni-kiel.de
Pörksen
E
E
Klatt
C
C
Bunse
A
A
Theisen-Kunde
D
D
Brinkmann
R
R
Birngruber
R
R
Laqua
H
H
Roider
J
J
D000328:Adult; D001769:Blood; D001813:Blood-Retinal Barrier; D001826:Body Fluids; D005122:Exudates and Transudates; D005260:Female; D005451:Fluorescein Angiography; D006801:Humans; D017075:Laser Coagulation / Q000379:methods*; D008297:Male; D008875:Middle Aged; D019060:Minimally Invasive Surgical Procedures; D010857:Pigment Epithelium of Eye / Q000601:surgery*; D012164:Retinal Diseases / Q000150:complications / Q000175:diagnosis / Q000601:surgery*; D012189:Retrospective Studies; D041623:Tomography, Optical Coherence; D016896:Treatment Outcome; D014792:Visual Acuity