Subthreshold laser therapy with a standardized macular treatment pattern in chronic central serous chorioretinopathy

Abstract

There is an ongoing controversial debate about the effectiveness of laser treatments in chronic central serous chorioretinopathy (cCSC). We performed a prospective non-randomized interventional study to learn about the effects of a subthreshold laser treatment (Topcon Endpoint Management™, Topcon Healthcare Inc., Tokyo, Japan) in patients with cCSC. Patients with cCSC and a minimum symptom duration of 4 months were included and treated with a standardized laser pattern covering the macular area. Retreatment was performed every 3 months if persistent subretinal fluid was observed. The primary endpoint was resolution of subretinal fluid at 6 months. Further outcome parameters included best corrected visual acuity, microperimetry, central macular and subfoveal choroidal thickness. A total of 42 eyes of 39 patients were included. Mean patient age was 48\u2009±\u200910.6 years (range 25–67). Mean symptomatic time before inclusion into the study was 134\u2009±\u2009133.4 weeks (16–518). Before inclusion, 78.6% of the patients had failed to resolve subretinal fluid under mineralocorticoid receptor antagonists and 14.3% had a recurrence after half-dose photodynamic therapy. Complete resolution of subretinal fluid was observed in 42.9% at 6 months and in 53.8% at 12 months after baseline. Central retinal thickness decreased from 398\u2009±\u2009135 µm to 291\u2009±\u200968 µm (p\u2009<\u20090.001), subfoveal choroidal thickness changed slightly (430\u2009±\u2009116 µm to 419\u2009±\u2009113 µm, p\u2009=\u20090.026), microperimetry-derived macular function improved by 19.1\u2009±\u20094.7 dB to 21.3\u2009±\u20094.8 dB (p\u2009=\u20090.008) and mean BCVA improved by 4.9\u2009±\u20098.6 ETDRS letters (p\u2009<\u20090.001). The results show that the investigated laser treatment is effective in reducing subretinal fluid and leads to an improvement of functional parameters.