First Author: E.Ivanova RUSSIA
Co Author(s): P. Volodin G. Zheltov
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To evaluate the efficacy and safety of selective influence of short laser pulses on retinal pigment epithelium in patients with chronic central serous chorioretinopathy.
Laser Retinal Surgery Department, The S. Fyodorov Eye Microsurgery Federal State Institution, Moscow, Russia The centre of Laser-Optics Technologies for Medicine and Biology, B.I. Stepanov Institute of Physics, Minsk, Belarus
Fifteen eyes of 15 patients with chronic central serous chorioretinopathy lasting longer than 3 months were treated with short laser pulses. All patients had undergone a complete ophthalmologic examination. Changes in best-correct visual acuity, central macular thickness and macular sensitivity by microperimetry were evaluated. Micropulse laser treatment was performed with IRIDEX IQ 577. Theoretical model, taking into account thermal properties of chorioretinal complex was used for estimation of parameters of laser pulses. Parameters were optimized to deliver maximal energy in pigment epithelium and keep retina undamaged. Every patient was followed-up 1 and 3 months after laser treatment. Short laser pulses were applied to the surrounding areas of leakage observed on fluorescein angiogram and/or pigment epithelium detachment.
Mean age of patients was 47,4 years. The best-correct visual acuity was 0,67±0,20, which was improved to 0,82±0,16 at the 1 month follow-up and 0,91±0,15 at the final follow-up. Central macular thickness was 354,3±49,6 μm which was changed to 269,6±24,5 μm at the 1 month follow-up and 245,2±28,7 μm at final follow-up. Subretinal fluid was eliminated in all eyes by 3 months after treatment. Short laser pulses did not cause any evidence of photoreceptor damage was observed on optical coherence tomography. In all cases, there was no detectable scotoma in any of the laser-treated lesions by microperimetry data obtained after the complete resolution of subretinal fluid. All short laser spots were undetectable by colour fundus photography, infrared reflectance imaging, autofluorescence and fluorescein angiography 3 months after treatment.
The new technique of selective influence of short laser pulses on retinal pigment epithelium cells showed efficacy and safety in treating chronic central serous chorioretinopathy especially if the pigment epithelium leak is located close to the fovea.