title: Subthreshold diode laser micropulse photocoagulation versus intravitreal injections of bevacizumab in the treatment of central serous chorioretinopathy.
abstract: OBJECTIVE
  To evaluate the treatment of central serous chorioretinopathy (CSC) with either subthreshold diode laser MicroPulse (SDM) or intravitreal bevacizumab (BCZ).
  
  
  METHODS
  This comparative, controlled, prospective study conducted over a period of 10 months examined 52 eyes of 52 patients with (a) treatment with SDM at the active leakage site guided by fluorescein angiography (FA) (n=16 eyes), (b) intravitreal injection of 1.25 mg BCZ (n=10 eyes), or (c) observation (n=26 eyes). Outcome measures included changes in retinal pigment epithelium (RPE) leakage at FA, central macular thickness (CMT), best-corrected visual acuity (BCVA), and 10° macular perimetry.
  
  
  RESULTS
  At the end of the study, there was 12.5% persistent leakage in the SDM, compared with 60% in the BCZ and 92% in the control group. Mean CMT decreased by 94 μm in the SDM, 38 μm in the BCZ, and did not change in the control group. Mean BCVA improved more than 6 early treatment of diabetic retinopathy study letters in the SDM, decreased by one letter in the BCZ, and by two letters in the control group. In the SDM group, mean perimetric deficit improved by 1.5 decibels and corrected lost variance by 2.6. In the BCZ, it improved by 0.6, and in the control group by 0.5. Retreatment was required in 7/16 eyes of the SDM group (43.75%), and in 5/10 eyes of the BCZ group (50%).
  
  
  CONCLUSIONS
  SDM photocoagulation was superior to intravitreal injections of 1.25 mg BCZ in the treatment of CSC, which resulted in enhanced visual acuity and macular perimetry.
authors.affiliation: Unit of Vitreo-Retinal Surgery, Department of Ophthalmology, Goethe University, Frankfurt am Main, Germany. Michael.Koss@me.com
authors.forename: M J
authors.initials: MJ
authors.lastname: Koss
authors.forename: I
authors.initials: I
authors.lastname: Beger
authors.forename: F H
authors.initials: FH
authors.lastname: Koch
mesh_terms: D000328:Adult; D020533:Angiogenesis Inhibitors / Q000008:administration & dosage*; D061067:Antibodies, Monoclonal, Humanized / Q000008:administration & dosage*; D000068258:Bevacizumab; D056833:Central Serous Chorioretinopathy / Q000503:physiopathology / Q000628:therapy*; D005260:Female; D005451:Fluorescein Angiography; D006801:Humans; D007429:Intraocular Pressure / Q000502:physiology; D058449:Intravitreal Injections; D017075:Laser Coagulation / Q000379:methods*; D054023:Lasers, Semiconductor / Q000627:therapeutic use*; D008266:Macula Lutea / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D055213:Retinal Pigment Epithelium / Q000503:physiopathology; D014792:Visual Acuity / Q000502:physiology; D014794:Visual Fields / Q000502:physiology
chemical_list: D020533:Angiogenesis Inhibitors; D061067:Antibodies, Monoclonal, Humanized; D000068258:Bevacizumab
references.citation: Ophthalmology. 2002 Oct;109(10):1834-7
references.pmid: 12359603
references.citation: Ophthalmologica. 2011;225(1):37-40
references.pmid: 20693820
references.citation: Arch Ophthalmol. 1994 Aug;112(8):1057-62
references.pmid: 8053819
references.citation: Retina. 2010 Nov-Dec;30(10):1698-703
references.pmid: 20539254
references.citation: Acta Ophthalmol. 2008 Mar;86(2):126-45
references.pmid: 17662099
references.citation: Jpn J Ophthalmol. 2009 Jan;53(1):52-56
references.pmid: 19184311
references.citation: Retina. 2007 Jun;27(5):629-34
references.pmid: 17558327
references.citation: Br J Ophthalmol. 2007 Sep;91(9):1230-3
references.pmid: 17475701
references.citation: Korean J Ophthalmol. 2010 Jun;24(3):155-8
references.pmid: 20532141
references.citation: Eur J Ophthalmol. 2008 Nov-Dec;18(6):934-40
references.pmid: 18988165
references.citation: Am J Ophthalmol. 1983 Apr;95(4):457-66
references.pmid: 6682293
references.citation: Ophthalmic Surg Lasers Imaging. 2007 Nov-Dec;38(6):484-90
references.pmid: 18050811
references.citation: Ophthalmologica. 2009;223(4):263-8
references.pmid: 19339810
references.citation: Retina. 2010 Jan;30(1):100-6
references.pmid: 20010322
references.citation: Retina. 2007 Nov-Dec;27(9):1168-73
references.pmid: 18046220
references.citation: Clin Exp Ophthalmol. 2009 Nov;37(8):801-5
references.pmid: 19878226
references.citation: Semin Ophthalmol. 2003 Sep;18(3):147-53
references.pmid: 15513476
references.citation: Am J Physiol Heart Circ Physiol. 2006 Feb;290(2):H560-76
references.pmid: 16172168
references.citation: Eur J Ophthalmol. 2009 Jul-Aug;19(4):613-7
references.pmid: 19551677
references.citation: Ophthalmology. 2008 Dec;115(12):2229-34
references.pmid: 19041477
references.citation: Curr Eye Res. 2010 Feb;35(2):91-8
references.pmid: 20136418
references.citation: Am J Physiol Heart Circ Physiol. 2006 Feb;290(2):H547-59
references.pmid: 16172161
references.citation: Ann Ophthalmol. 1977 Dec;9(12):1567-72
references.pmid: 564655
references.citation: Ophthalmology. 2005 Dec;112(12):2088-94
references.pmid: 16325707
references.citation: Retina. 2003 Jun;23(3):288-98
references.pmid: 12824827
references.citation: Trans Am Ophthalmol Soc. 1986;84:799-845
references.pmid: 3590481
references.citation: Ophthalmology. 1984 Dec;91(12):1554-72
references.pmid: 6084221