First Author: H.Kaymak GERMANY
Co Author(s): A. Fricke C. Ullmann G. Auffarth D. Breyer K. Klabe R. Fulga
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In modern ophthalmological laser therapy cell gentle laser technologies are increasingly used. Those technologies promise a good treatment success, due to their mode of action, the stimulation of cell regeneration processes by short low-energy-pulses. This paper reported about the current success of selective laser therapy in our practice on patients with chronic central serous chorioretinopathy (CSR) by treatment with a Nano-Laser.
Internationale Innovative Ophthalmochirurgie Düsseldorf, Germany; International Vision Correction Research Network, Germany
Our retrospective study includes 15 patients with acute and 43 patients with chronic CSR. Chronic CSR was defined with duration of disease at least 4 months; partly nonresponders to Diamox, photodynamic therapy (PDT), Eplerenone and Spironolactone. We analyzed microperimetry (Maia; centrevue), OCT results (Cirrus HD-OCT; Zeiss / DRI OCT; Topcon), angiography images, autofluorescence images (Visucam; Zeiss / DRI OCT; Topcon / California; Optos), visual acuity with ETDRS charts and Amsler. The treatment (Pattern scanning) of the leakages were performed using the 2RT (Retinal Rejuvenation) Nano-Laser from Ellex Medical Lasers Ltd. with a spot size of 400 microns and an exposure time of 3 ns.
Acute CSR: Mean age of patients was 42 ± 7 years, all of them were male and the duration of symptomatics was less than 2 months. Visual acuity increase from pre- to post-treatment from 0.63 ± 0.3 to 0.85 ± 0.16. The microperimetry has shown an improvement of retina sensitivity from 24.8 ± 3.6 to 28.7 ± 2.6 dB. The decline of subretinal fluid were observed after 1, 2 and 3 months after treatment. Respectively, 75%, 80% or 100% of the patients showed a complete resorption. The recurrence rate was 33% after 4.5 month from the first treatment. Chronic CSR: Mean age of patients was 49 ± 11 years, 77% of them were male and the duration of symptomatics was 22 ± 23 months. Visual acuity increase from pre- to post-treatment from 0.67 ± 0.3 to 0.8 ± 0.2. The microperimetry has shown an improvement of retina sensitivity from 24.5 ± 3.3 to 26.5 ± 3.7 dB. 67%, 88% or 95% of the patients showed a complete resorption of subretinal fluid after 1, 2 and 3 months after first treatment. The recurrence rate was 33% after 5 month from the first treatment.
Overall, our results show that the applied selective laser therapy with 3 ns exposure time represents an interesting alternative to PDT. Further studies must confirm this trend by much larger sample sizes. A concomitant therapy with non-steroidal antiphylogistica is to recommend to prevent the formation of a macular edema.