Selective Retina Therapy in Patients with Central Serous Chorioretinopathy

Jae Min Kim; Joo Yeon Kim

doi:10.3341/jkos.2018.59.10.915

Journal List > J Korean Ophthalmol Soc > v.59(10) > 1103093

Go to TopGo to Top Go to BottomGo to Bottom

TOOLS

Kim and Kim: Selective Retina Therapy in Patients with Central Serous Chorioretinopathy

Original Article

J Korean Ophthalmol Soc 2018;59(10):915-921.

Published online: 8 September 2018

DOI: https://doi.org/10.3341/jkos.2018.59.10.915

Selective Retina Therapy in Patients with Central Serous Chorioretinopathy

Jae Min Kim, M.D., Joo Yeon Kim, M.D.

Myung-Gok Eye Resarch Institute, Department of Ophthalmology, Kim's Eye Hospital, Konyang University College of Medicine, Seoul, Korea

Address reprint requests to Joo Yeon Kim, MD Department of Ophthalmology, Kim's Eye Hospital, #136 Yeongsin-ro, Yeongdeungpo-gu, Seoul 07301, Korea Tel: 82-2-2639-7777, Fax: 82-2-2639-7766 E-mail: redmanson@kimeye.com

Conflicts of Interest: The authors have no conflicts to disclose.

Received 14 December 201721 May 2018 Accepted 27 September 27

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Purpose

We evaluated the visual outcomes and changes in central macular thickness in patients with central serous chorior-etinopathy who underwent selective retina therapy.

Methods

Patients diagnosed with central serous chorioretinopathy were included in the study. Fundus fluorescein angiography was performed before laser treatment. We reviewed the charts of 16 patients (17 eyes) in terms of age, sex, best-corrected visu-al acuity, intraocular pressure, slit lamp examination, the time from diagnosis to laser treatment, the site of laser treatment and side-effects. Optical coherence tomography was performed before laser treatment and 1 month later; the central macular thick-nesses were compared.

Results

The average best-corrected visual acuity at diagnosis and 1 month after laser treatment were 0.20 and 0.12 (logMAR) respectively. The improvement was thus 0.08 (logMAR). The average central macular thickness decreased by 174.78 μ m from 326.53 ± 59 µm at baseline to 151.75 ± 15 μ m 1 month after selective retina therapy.

Conclusions

Selective laser therapy afforded favorable visual and structural outcomes and was not associated with a risk of scotoma or other untreatable side-effects.

Keywords: Best correct visual acuity, Central macular thickness, Central serous chorioretinopathy, Selective retina therapy

References

1. Fujita K, Shinoda K, Matsumoto CS. . Microperimetric evalua-tion of chronic central serous chorioretinopathy after half-dose photodynamic therapy. Clin Ophthalmol. 2012; 6:1681–7.

2. Wang M, Munch IC, Hasler PW. . Central serous chorioretinopathy. Acta Ophthalmol. 2008; 86:126–45.

3. Oh J, Kwon OW, Kim MH. . Photodynamic therapy for chronic central serous chorioretinopathy: multicenter study of 65 cases. J Korean Ophthalmol Soc. 2009; 50:390–8.

4. Gass JD. Pathogenesis of disciform detachment of the neuroepithelium. Am J Ophthalmol. 1967; 63((Suppl 1)):1–139.

5. Yannuzzi LA, Shakin JL, Fisher YL, Altomonte MA. Peripheral retinal detachments and retinal pigment epithelial atrophic tracts secondary to central serous pigment epitheliopathy. Ophthalmology. 1984; 91:1554–72.

6. Yannuzzi LA, Slakter JS, Gross NE. . Indocyanine green an-giography-guided photodynamic therapy for treatment of chronic central serous chorioretinopathy: a pilot study. Retina. 2003; 23:288–98.

7. Hee MR, Puliafito CA, Wong C. . Optical coherence tomog-raphy of central serous chorioretinopathy. Am J Ophthalmol. 1995; 120:65–74.

8. Montero JA, Ruiz-Moreno JM. Optical coherence tomography characterisation of idiopathic central serous chorioretionpathy. Br J Ophthalmol. 2005; 89:562–4.

9. Spitznas M. Pathogenesis of central serous retinopathy: a new working hypothesis. Graefes Arch Clin Exp Ophthalmol. 1986; 224:321–4.

10. Spaide RF, Goldbaum M, Wong DW. . Serous detachment of the retina. Retina. 2003; 23:820–46.

11. Yannuzzi LA. Central serous chorioretinopathy: a personal perspective. Am J Ophthalmol. 2010; 149:361–3.

12. Quin G, Liew G, Ho IV. . Diagnosis and interventions for cen-tral serous chorioretinopathy: review and update. Clin Exp Ophthalmol. 2013; 41:187–200.

13. Wood EH, Karth PA, Sanislo SR. . Nondamaging retial laser therapy for treatment of central serous chorioretinopathy: what is the evidence? Retina. 2017; 37:1021–33.

14. Roider J, Brinkmann R, Wirbelauer C. . Retinal sparing by se-lective retinal pigment epithelial photocoagulation. Arch Ophthalmol. 1999; 117:1028–34.

15. Brinkmann R, Roider J, Birngruber R. Selective retina therapy (SRT): a review on methods, techniques, preclinical and first clin-ical results. Bull Soc Belge Ophtalmol. 2006; 302:51–69.

16. Roider J, Liew SH, Klatt C. . Selective retina therapy (SRT) for clinically significant diabetic macular edema. Graefes Arch Clin Exp Ophthalmol. 2010; 248:1263–72.

17. Piccolino F, Eandi CM, Ventre L. . Photodynamic therapy for chronic central serous chorioretinopathy. Retina. 2003; 23:752–63.

18. Scholz P, Altay L, Fauser S. Comparison of subthreshold micro-pulse laser (577 nm) treatment and half-dose photodynamic therapy in patients with chronic central serous chorioretinopathy. Eye (Lond). 2016; 30:1371–7.

19. Kang S, Park YG, Kim JR. . Selective retina therapy in patients with chronic central serous chorioretinopathy: a pilot study. Medicine (Baltimore). 2016; 95:e2524.

20. Klatt C, Saeger M, Oppermann T. . Selective retina therapy for acute central serous chorioretinopathy. Br J Ophthalmol. 2011; 95:83–8.

21. Brinkmann R, Roider J, Birngruber R. Selective retina ther-apy(SRT): a review on methods, techniques, preclinical and first clinical results. Bull Soc Belge Ophtalmol. 2006; 302:51–69.

22. Elsner H, Pörksen E, Klatt C. . Selective retina therapy in pa-tients with chronic central serous chorioretinopathy. Graefes Arch Clin Exp Ophthalmol. 2006; 244:1638–45.

23. Ross A, Ross AH, Mohamed Q. Review and update of central se-rous chorioretinopathy. Curr Opin Ophthalmol. 2011; 22:166–73.

24. Framme C, Walter A, Berger L. . Selective retina therapy in acute and chronic-recurrent central serous chorioretinopathy. Ophthalmologica. 2015; 234:177–88.

Figure 1.

Case 12. Selective laser therapy was applied to the leakage point which is indicated by dotted circle on fundus flu-orescin angiography at baseline.

Figure 2.

Case 5. Large subretinal fluid was observed on base-line optical coherence tomography.

Figure 3.

Case 5. The subretinal fluid were completely re-solved at 1 months after selective retina therapy.

Table 1.

Characteristics of 16 patients (17 eyes) with central serous chorioretinopathy

Eye	Sex	Age (years)	HTN/DM	Side	Diagnosis to laser	Maximum energy (μ J)	Last follow up from first laser
1	M	55	X/X	L	9 months	85	5 months
2	M	39	X/X	R	3 months	130	5 months
3	M	37	X/X	R	5 months	110	5 months
4	F	56	X/X	R	2 months	150	5 months
5	M	63	O/O	R	3 months	130	5 months
6	M	57	X/X	R	1 month	30	4 months
7	M	49	X/X	R	3 months	90	11 months
8	M	57	X/X	R	2 months	30	6 months
9	M	46	X/X	R	3 months	110	Follow up loss
10	F	61	X/X	R	3 week	130	6 months
11	F	61	X/X	L	4 months	120	1 month
12	M	64	O/O	R	2 months	130	4 months
13	M	50	O/X	R	8 months	100	9 months
14	M	42	X/X	L	1 month	120	2 months
15	M	53	O/X	L	1 month	130	3 months
16	F	55	X/X	R	1 month	140	2 months
17	M	71	O/X	L	2 months	160	4 months

HTN = hypertension; DM = diabetes mellitus; M = male; F = female; L = left eye; R = right eye; O = presence; X = absence.

Table 2.

Change of best-corrected visual acuity (logMAR) in selective retina therapy-treated patients with central serous chorioretin-opathy

Eye	Initial VA (logMAR)	VA after therapy (logMAR)	VA improvement (logMAR)	p-value^*
1	0.30	0.22	0.1	0.041
2	0.10	0.00	0.2
3	0.05	0.00	0.1
4	0.05	0.05	0
5	0.40	0.15	0.3
6	0.40	0.15	0.3
7	0.52	0.22	0.3
8	0.40	0.22	0.2
9	0.22	-	-
10	0.05	0.05	0
11	0.05	0.05	0
12	0.00	0.00	0
13	0.15	0.00	0.3
14	0.22	0.40	-0.2
15	0.10	0.05	0.1
16	0.15	0.10	0.1
17	0.22	0.30	-0.1

VA = visual acuity.

^* Wilcoxon signed rank test.

Table 3.

Change of central retinal thickness (CRT) in selective retina therapy-treated patients with central serous chorioretinopathy

Eye	Baseline CRT (μ m)	CRT after therapy (μ m)	Decrease in CRT (μ m)	p-value^*
1	340	177	163	0.001
2	500	150	350
3	344	168	176
4	433	172	261
5	277	120	157
6	575	161	414
7	431	137	294
8	516	216	300
9	320	-	-
10	253	133	120
11	141	121	20
12	210	94	116
13	276	144	132
14	139	178	-39
15	308	203	105
16	302	113	189
17	186	141	45

^* Wilcoxon signed rank test.

TOOLS

Similar articles