Navigated Laser Photocoagulation in Patients With Non-Resolving and Chronic Central Serous Chorioretinopathy

Graefes Arch Clin Exp Ophthalmol. 2018 Sep;256(9):1581-1588. doi: 10.1007/s00417-018-4031-8. Epub 2018 Jun 6.

Abstract

Purpose: To evaluate the efficacy of navigated focal laser photocoagulation in patients with chronic central serous chorioretinopathy (CSCR) and active leakage on fluorescein angiography (FA).

Methods: Thirty-two eyes of 32 patients (age 48 ± 11, m/f = 24/8) with persistent or recurrent CSCR (> 3 months) who received navigated laser photocoagulation (Navilas®) of leaking point(s) between June 2013 and 2016 were included in this retrospective case series. Outcome parameters after 4 weeks and 3 months were the number of patients presenting with complete resolution of subretinal fluid, the volume of subretinal fluid measured on SD-OCT (Spectralis Heidelberg Engineering©), and best corrected visual acuity (BCVA/ (Snellen equivalent).

Results: Complete resolution of subretinal fluid was achieved in 17 eyes (50%) after 4 weeks and in 24 eyes (75%) after 3 months with an average number of 1.3 laser procedures (range 1-3). Five eyes displayed a nearly complete resolution with a reduction of over 80% of the subretinal fluid compared to baseline. Three eyes showed no reduction in subretinal fluid. BCVA improved from median 0.58 (range 0.16-1.25) to 0.66 (0.16-1.0) (p = 0.001). The seven patients who had been treated within the central 1 mm of the ETDRS-OCT Grid but outside the avascular foveal zone showed an improvement of BCVA from median 0.6 (range 0.2-1.0) to 0.8 (0.2-1.0). No patient experienced a treatment-induced visual loss.

Conclusions: Laser treatment with Navilas® using eye tracking and FA-based planning is a safe and effective alternative therapy in patients with chronic CSCR.

Keywords: Central serous chorioretinopathy; Navigated laser photocoagulation.

MeSH terms

  • Adult
  • Aged
  • Central Serous Chorioretinopathy / diagnosis
  • Central Serous Chorioretinopathy / metabolism
  • Central Serous Chorioretinopathy / surgery*
  • Chronic Disease
  • Female
  • Fluorescein Angiography
  • Humans
  • Laser Coagulation / methods*
  • Male
  • Middle Aged
  • Retrospective Studies
  • Subretinal Fluid / metabolism
  • Surgery, Computer-Assisted / methods*
  • Visual Acuity