title: Large-spot subthreshold transpupillary thermotherapy for chronic serous macular detachment.
abstract: OBJECTIVE
  To report the effect of subthreshold transpupillary thermotherapy (TTT) in treating serous detachment of the neurosensory retina secondary to chronic central serous chorioretinopathy (CCSC).
  
  
  METHODS
  Seven eyes from five patients with CCSC, persistent serous detachment of the neurosensory retina and a clinical course of between 12 and 60 months were treated. All eyes received large-spot TTT guided by indocyanine green angiography (ICGA). Subthreshold TTT was performed using an 810 nm diode laser with a spot size of 3.0 mm (power was set at 350 mW). Treatment was applied for 60 seconds to the areas of choroidal hyperfluorescence on ICGA.
  
  
  RESULTS
  The mean number of TTT sessions was 1.4 ± 0.5. All eyes were followed up for at least 6 months (mean 9.6 ± 3.2 standard deviation; range 6-12 months). The mean logarithm of the minimum angle of resolution best-corrected visual acuity was significantly better compared with baseline. All TTT-treated eyes had stable or improved vision (P < 0.001). Mean optical coherence tomography (OCT) central foveal thickness was significantly lower in all patients (P < 0.001) compared with pretreatment OCT, with a reduction in subretinal fluid and resolution of serous detachment associated with anatomical fovea restoration. No patient had any treatment-related side effects.
  
  
  CONCLUSIONS
  Modified subthreshold TTT appears to have a beneficial effect in treating patients with CCSC and persistent neurosensory detachment. The encouraging results and lack of visually significant complications suggest that further investigation is warranted.
authors.affiliation: San Paolo Ophthalmic Center, San Antonio Hospital, Padova, Italy;
authors.forename: Giuseppe Lo
authors.initials: GL
authors.lastname: Giudice
authors.forename: Valentina
authors.initials: V
authors.lastname: de Belvis
authors.forename: Marco
authors.initials: M
authors.lastname: Tavolato
authors.forename: Alessandro
authors.initials: A
authors.lastname: Galan