RESUMEN
BACKGROUND: Subthreshold microsecond pulsing laser is an increasingly common treatment approach for central serous chorioretinopathy. However, there is no literature available on the safety of microsecond laser using different fluence settings in this disease. While many publications can be obtained from conventional microsecond pulsing lasers, few parameter sets are published with the navigated microsecond pulsing laser. Therefore, this study aims to investigate the safety of different parameter sets in subthreshold microsecond pulsing laser treatments. METHODS: In this retrospective chart review, consecutive patients with central serous chorioretinopathy (> 3 months duration of symptoms) treated with navigated subthreshold microsecond pulsing laser and a follow up of at least five months after microsecond laser application were included. For each patient, the treatment parameters, plan layout, and adverse events related to laser were evaluated. Secondary outcomes included best-corrected visual acuity and anatomical improvements (central retinal thickness). RESULTS: One hundred and one eyes were included in the observation and followed for a mean of 10 months (range 5-36). Although a larger range of parameter sets and fluence settings have been used, no patient demonstrated adverse events from navigated microsecond pulsing laser. While 88% of the cases demonstrated stability, 13 cases lost five or more letters due to the persistence of the subretinal fluid. In mean, a best-corrected visual acuity improvement of 0.07logMar (± 0.2) was seen (p = 0.02). In 51% of the patients, a statistically significant improvement of the central retinal thickness was noted at the last follow-up with a mean thickness reduction of 70 µm (± 143) (p < 0.01). CONCLUSION: In conclusion, none of the used parameter sets lead to tissue damage (when using a cautious titration) and, in summary, lead to an improvement in subretinal fluid and improvement in visual acuity. However, further prospective studies are needed to correctly identify the dependency of the treatment strategy on the outcome criteria.
RESUMEN
PURPOSE: To evaluate the choroidal vascularity index of eyes for acute and chronic central serous chorioretinopathy patients using swept-source optical coherence tomography generated en-face scans. METHODS: This was a retrospective study, in which slabs of en-face optical coherence tomography scans, at 5 µm intervals, spanning from the retina to choroid, were binarized using a validated algorithm to calculate choroidal vascularity index. The choroidal vascularity index was defined as the ratio between the choroidal vascular luminal area and the total choroidal area. Choroidal vascularity index was calculated for all the slabs of every subject in both the groups. RESULTS: A total of 30 eyes for each acute and chronic central serous chorioretinopathy groups were recruited. The mean choroidal vascularity index of the acute group was 45.21% ± 2.25% at the choriocapillaris, which increased to the maximal value of 48.35% ± 2.06% at 75% depth of the choroidal thickness and 45.31% ± 3.27% at the choroidoscleral interface; whereas for the chronic group, the mean choroidal vascularity index was 44.76% ± 2.60% at the choriocapillaris, which maximized at 50% choroidal depth (48.70% ± 1.32%) and then returned to 45.41% ± 6.02% at the choroidoscleral interface. CONCLUSION: For both groups, the choroidal vascularity index increased from choriocapillaris to maximum values at mid-choroid and returned to almost the choriocapillaris value at the choroidoscleral interface.
