2025 - 4 Issue

Original article

Treatment of Patients with Central Serous Chorioretinopathy using Navigated Laser Photocoagulation

Full Text links

Summary

Aim: To report the results of treatment of patients with central serous chorioretinopathy treated with a Navilas laser.

Material and Methods: We retrospectively evaluated the results of the treatment of 39 eyes of 37 patients with acute form of central serous chorioretinopathy, who did not respond to conventional treatment. In these patients we performed focal laser treatment at the point of leakage (hotspot) using a Navilas guided laser.

Results: 3 patients did not report for the check-up, of the remaining 36 eyes, complete liquid absorption was achieved in 32. Retreatment was necessary in 2 patients, choroidal neovascularization developed in one patient, and in one patient fluid absorption was not achieved even after retreatment.

Conclusion: Focal laser treatment of hotspots in patients with central serous chorioretinopathy is still a very effective treatment method. Juxtafoveolar lesions can also be treated with a high degree of safety using a Navilas navigation laser.

References

  1. Maruko I, Iida T, Sugano Y, Ojima A, Ogasawara M, Spaide, RF. Subfoveal choroidal thickness after treatment of central serous chorioretinopathy. Ophthalmology, (2010) 117(9), 1792-1799.
  2. Gilbert CM, Owens SL, Smith PD, Fine SL. Long-term follow-up of central serous chorioretinopathy. Br J Ophthalmol. 1984;68:815-
  3. Manethová K, Ernest J. Retrospective analysis of the presence of choroidal neovascularisation using optical coherence tomography angiography in the treatment of chronic central serous chorioretinopathy with the aid of photodynamic therapy. Cesk Slov Oftalmol. 2021;77(3):122-131.
  4. Yannuzzi LA. Type A behavior and central serous chorioretinopathy. Trans Am Ophthalmol Soc. 1986;84:799-845.
  5. Iida T, Yannuzzi LA, Spaide RF, Borodoker N, Carvalho CA, Negrao S. Cystoid macular degeneration in chronic central serous chorioretinopathy. Retina. 2003 Feb;23(1):1-7.
  6. Carvalho-Recchia CA, Yannuzzi LA, Negrão S, et al. Corticosteroids and central serous chorioretinopathy. Ophthalmology. 2002 Oct;109(10):1834-1837.
  7. Daruich A, Matet A, Dirani A, et al. Central serous chorioretinopathy: Recent findings and new physiopathology hypothesis. Prog Retin Eye Res. 2015 Sep;48:82-118.
  8. Karadimas P, Kapetanios A, Bouzas EA. Central serous chorioretinopathy after local application of glucocorticoids for skin disorders. Arch Ophthalmol. 2004 May;122(5):784-786.
  9. Haimovici R, Koh S, Gagnon DR, Lehrfeld T, Wellik S. Central Serous Chorioretinopathy Case-Control Study Group. Risk factors for central serous chorioretinopathy: a case-control study. Ophthalmology. 2004 Feb;111(2):244-249.
  10. McCannel TA, Chmielowski B, Finn RS, et al. Bilateral subfoveal neurosensory retinal detachment associated with MEK inhibitor use for metastatic cancer. JAMA Ophthalmol. 2014 Aug;132(8):1005-1009.
  11. Aliferis K, Petropoulos IK, Farpour B, Matter MA, Safran AB. Should central serous chorioretinopathy be added to the list of ocular side effects of phosphodiesterase 5 inhibitors? Ophthalmologica. 2012;227(2):85-89.
  12. Pierce KK, Lane RG. Central serous chorioretinopathy associated with the use of ephedra. Retin Cases Brief Rep. 2009 Fall;3(4):376- 378.
  13. Kitzmann AS, Pulido JS, Diehl NN, Hodge DO, Burke JP. The incidence of central serous chorioretinopathy in Olmsted County, Minnesota, 1980-2002. Ophthalmology. 2008 Jan;115(1):169-173.
  14. Kim YT, Kang SW, Bai KH. Choroidal thickness in both eyes of patients with unilaterally active central serous chorioretinopathy. Eye (Lond). 2011 Dec;25(12):1635-1640.
  15. Uyama M, Matsunaga T, Matsubara I, Fukushima I, Takahashi K, Nishimura T. Indocyanine green angiography and pathophysiology of multifocal posterior pigment epitheliopathy. Retina. 1999;19(1):12-21.
  16. Imamura Y, Fujiwara T, Margolis R, Spaide RF. Enhanced depth imaging optical coherence tomography of the choroid in central serous chorioretinopathy. Retina, 2009;29(10):1469-1473.
  17. Lai TY, Wong RL, Chan WM. Long-Term Outcome of Half-Dose Verteporfin Photodynamic Therapy for the Treatment of Central Serous Chorioretinopathy (An American Ophthalmological Society Thesis). Trans Am Ophthalmol Soc. 2015;113:T8.
  18. Chan WM, Lai TY, Lai RY, Liu DT, Lam DS. Half-dose verteporfin photodynamic therapy for acute central serous chorioretinopathy: one-year results of a randomized controlled trial. Ophthalmology. 2008 Oct;115(10):1756-1765.
  19. Lee JY, Chae JB, Yang SJ, Kim JG, Yoon YH. Intravitreal bevacizumab versus the conventional protocol of photodynamic therapy for treatment of chronic central serous chorioretinopathy. Acta Ophthalmol 2011;89:e293-e294.
  20. van Dijk EHC, Fauser S, Breukink MB, et al. Half-dose photodynamic therapy versus high-density subthreshold micropulse laser treatment in patients with chronic central serous chorioretinopathy: the PLACE trial. Ophthalmology. 2018;125:1547-1555. doi: 10.1016/j.ophtha.2018.04.021
  21. Roca JA, Wu L, Fromow-Guerra J, et al. Yellow (577 nm) micropulse laser versus half-dose verteporfin photodynamic therapy in eyes with chronic central serous chorioretinopathy: results of the Pan-American Collaborative Retina Study (PACORES) Group. Br J Ophthalmol. 2018;102(12):1696-1700. doi:10.1136/bjophthalmol-2017-311291
  22. Ntomoka CG, Rajesh B, Muriithi GM, Goud A, Chhablani J. Comparison of photodynamic therapy and navigated microsecond laser for chronic central serous chorioretinopathy. Eye (Lond). 2018;32(6):1079-1086. doi:10.1038/s41433-018-0029-z
  23. Zhou F, Yao J, Jiang Q, Yang W. Efficacy of Navigated Laser Photocoagulation for Chronic Central Serous Chorioretinopathy: A Retrospective Observational Study. Dis Markers. 2022 Apr;20;2022.
  24. Müller B, Tatsios J, Klonner J, Pilger D, Joussen AM. Navigated laser photocoagulation in patients with non-resolving and chronic serous chorioretinopathy. Graefe’s Arch. Clin. Exp. Ophthalmol. 2018;256:1581-1588.
  25. Menghani R, Lu S. Case Series of Central Serous Chorioretinopathy (CSR) Treated with the Novel Navilas Navigated Laser System. Invest. Ophthalmol. Vis. Sci. 2012;53(14):5846.
  26. Jay C, Padmaja KR, Annie M, Subhadra J, Kozak I. Navigated focal laser photocoagulation for central serous chorioretinopathy, Clinical Ophthalmology, 2014;8:543-1547.
  27. Maltsev DS, Kulikov AN, Chhablani J. Clinical Application of Fluorescein Angiography-Free Navigated Focal Laser Photocoagulation in Central Serous Chorioretinopathy. Ophthalmic Surg Lasers Imaging Retina. 2019 Apr 1;50(4):e118-e124. doi: 10.3928/23258160- 20190401-16
  28. Chhablani, J, Kalra, G, Alkwatli, L. et al. Safety of various parameter sets with navigated microsecond pulsing laser in central serous chorioretinopathy. Int J Retin Vitr. 2021;7:62. doi.org/10.1186/ s40942-021-00335-3
  29. Hirano T, Iesato Y, Imai A, Toriyama Y, Kikushima W, Murata T. Effect of Laser wavelength on delivering appropriate laser burns through the opaque lens using a pattern scan laser. Ophthalmic Res. 2014;51(4):204-209.
  30. Wang J, Quan Y, Dalal R, Palanker D. Comparison of Continuous- -Wave and Micropulse Modulation in Retinal Laser Therapy. Invest Ophthalmol Vis Sci. 2017 Sep 1;58(11):4722-4732. doi: 10.1167/ iovs.17-21610
  31. Kaye R, Chandra S, Sheth J, Boon CJF, Sivaprasad S, Lotery A. Central serous chorioretinopathy: an update on risk factors, pathophysiology and imaging modalities. Prog Ret a Eye Res. 2020;79:p. 100865. doi: 10.1016/j.preteyeres.2020.100865