Graded subthreshold transpupillary thermotherapy for chronic central serous chorioretinopathy.
OBJECTIVE
To study the safety and efficacy of "graded" subthreshold transpupillary thermotherapy (TTT), a novel treatment protocol for chronic central serous chorioretinopathy (CSC) and an alternative to photodynamic therapy (PDT).


METHODS
This retrospective pilot study included 10 eyes with chronic CSC that underwent TTT with 810-nm continuous diode laser treatment using a subthreshold power (60% reduced from threshold) for 60 seconds. Treatment was repeated at 20% increase in power from the baseline if submacular fluid persisted on optical coherence tomography (OCT) after 1 month (graded fashion).


RESULTS
The mean chronic CSC duration was 20.3 ± 8.3 months. Eight eyes (80%) showed resolution of CSC on OCT. Mean number of TTT sittings required was 1.5. Although 5 eyes (50%) had 3 or more lines of improvement in Snellen visual acuity, 3 eyes (30%) had up to 2 lines of improvement. None of the patients developed macular burn or scar.


CONCLUSIONS
The safety enhanced graded subthreshold TTT was beneficial in patients with chronic CSC.
Department of Retina and Ocular Oncology, Aravind Eye Hospital, Avinashi Road, Coimbatore, Tamil Nadu, India. gjmanayath@yahoo.com
George J
GJ
Manayath
Venkatapathy
V
Narendran
Saurabh
S
Arora
Rodney J
RJ
Morris
Veerappan R
VR
Saravanan
Parag K
PK
Shah
D000328:Adult; D056833:Central Serous Chorioretinopathy / Q000628:therapy*; D002908:Chronic Disease; D005451:Fluorescein Angiography; D006801:Humans; D006979:Hyperthermia, Induced / Q000009:adverse effects / Q000379:methods*; D054023:Lasers, Semiconductor / Q000627:therapeutic use; D008297:Male; D008875:Middle Aged; D010865:Pilot Projects; D011680:Pupil; D012189:Retrospective Studies; D041623:Tomography, Optical Coherence; D016896:Treatment Outcome; D014792:Visual Acuity / Q000502:physiology