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Selective retina therapy with automatic real-time feedback-controlled dosimetry for chronic central serous chorioretinopathy in Korean patients

  • Retinal Disorders
  • Published:
Graefe's Archive for Clinical and Experimental Ophthalmology Aims and scope Submit manuscript

Abstract

Purpose

To evaluate the safety and efficacy of selective retina therapy (SRT) with real-time feedback-controlled dosimetry (RFD) in the treatment of chronic central serous chorioretinopathy (CSC).

Methods

In this retrospective case series study, 50 eyes of 49 patients with chronic CSC demonstrating focal or diffuse foveal leakages on fundus fluorescein angiography (FFA) were included. Following evaluation of test spots at temporal arcades, SRT (wavelength 527 nm, pulse repetition rate 100 Hz, pulse energy ramp with maximal 15 pulses) with retinal spot diameter of 200 μm was applied to the areas of each leakage observed on fluorescein angiography. Changes in mean best corrected visual acuity (BCVA), maximum macular thickness (MMT), subretinal fluid (SRF) height, and subfoveal choroidal thickness (SCT) were evaluated at 1, 2 and 3 months after treatment. RFD was used for adjusting the pulse energy. Eyes received a mean of 21.1 ± 18.1 treatment spots with a range of energies between 50uJ and 200uJ per pulse.

Results

Subretinal fluid (SRF) was completely resolved in 74% (37/50 eyes) at month 3. Mean BCVA (LogMAR) was improved from 0.44 ± 0.29 at baseline to 0.37 ± 0.32 at month 3 (p = 0.001). MMT was decreased from 335.0 ± 99.8 μm at baseline to 236.4 ± 66.4 μm after 3 months (p < 0.001). SRF height was decreased from 168.0 ± 77.3 μm at baseline to 29.0 ± 57.3 μm after 3 months (p < 0.001). However, the changes in SCT were not statistically significant (p = 0.48).

Conclusions

SRT treatment with RFD showed favorable visual and anatomical outcomes in patients with chronic CSC.

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References

  1. Nicholson B, Noble J, Forooghian F, Meyerle C (2013) Central serous chorioretinopathy: update on pathophysiology and treatment. Surv Ophthalmol 58:103–126

    Article  PubMed  PubMed Central  Google Scholar 

  2. Wang M, Munch IC, Hasler PW, Prunte C, Larsen M (2008) Central serous chorioretinopathy. Acta Ophthalmol 86:126–145

    Article  PubMed  Google Scholar 

  3. Spaide RF, Campeas L, Haas A, Yannuzzi LA, Fisher YL, Guyer DR, Slakter JS, Sorenson JA, Orlock DA (1996) Central serous chorioretinopathy in younger and older adults. Ophthalmology 103:2070–2079 discussion 2079-2080

    Article  CAS  PubMed  Google Scholar 

  4. Guyer DR, Yannuzzi LA, Slakter JS, Sorenson JA, Ho A, Orlock D (1994) Digital indocyanine green videoangiography of central serous chorioretinopathy. Arch Ophthalmol 112:1057–1062

    Article  CAS  PubMed  Google Scholar 

  5. Spaide RF, Goldbaum M, Wong DW, Tang KC, Iida T (2003) Serous detachment of the retina. Retina 23:820–846 quiz 895-826

    Article  PubMed  Google Scholar 

  6. Spitznas M (1986) Pathogenesis of central serous retinopathy: a new working hypothesis. Graefes Arch Clin Exp Ophthalmol 224:321–324

    Article  CAS  PubMed  Google Scholar 

  7. Klein ML, Van Buskirk EM, Friedman E, Gragoudas E, Chandra S (1974) Experience with nontreatment of central serous choroidopathy. Arch Ophthalmol 91:247–250

    Article  CAS  PubMed  Google Scholar 

  8. Gilbert CM, Owens SL, Smith PD, Fine SL (1984) Long-term follow-up of central serous chorioretinopathy. Br J Ophthalmol 68:815–820

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  9. Bujarborua D (2001) Long-term follow-up of idiopathic central serous chorioretinopathy without laser. Acta Ophthalmol Scand 79:417–421

    Article  CAS  PubMed  Google Scholar 

  10. Koskela P, Laatikainen L, von Dickhoff K (1994) Contrast sensitivity after resolution of central serous retinopathy. Graefes Arch Clin Exp Ophthalmol 232:473–476

    Article  CAS  PubMed  Google Scholar 

  11. Moon JW, Yu HG, Kim TW, Kim HC, Chung H (2009) Prognostic factors related to photodynamic therapy for central serous chorioretinopathy. Graefes Arch Clin Exp Ophthalmol 247:1315–1323

    Article  CAS  PubMed  Google Scholar 

  12. Reibaldi M, Cardascia N, Longo A, Furino C, Avitabile T, Faro S, Sanfilippo M, Russo A, Uva MG, Munno F, Cannemi V, Zagari M, Boscia F (2010) Standard-fluence versus low-fluence photodynamic therapy in chronic central serous chorioretinopathy: a nonrandomized clinical trial. Am J Ophthalmol 149(307–315):e302

    Google Scholar 

  13. Lai TY, Chan WM, Li H, Lai RY, Liu DT, Lam DS (2006) Safety enhanced photodynamic therapy with half dose verteporfin for chronic central serous chorioretinopathy: a short term pilot study. Br J Ophthalmol 90:869–874

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  14. Ruiz-Moreno JM, Lugo FL, Armada F, Silva R, Montero JA, Arevalo JF, Arias L, Gomez-Ulla F (2010) Photodynamic therapy for chronic central serous chorioretinopathy. Acta Ophthalmol 88:371–376

    Article  PubMed  Google Scholar 

  15. Khosla PK, Rana SS, Tewari HK, Azad RU, Talwar D (1997) Evaluation of visual function following argon laser photocoagulation in central serous retinopathy. Ophthalmic Surg Lasers 28:693–697

    CAS  PubMed  Google Scholar 

  16. Little HL (1976) Complications of argon laser retinal photocoagulation: a five-year study. Int Ophthalmol Clin 16:145–159

    CAS  PubMed  Google Scholar 

  17. Brinkmann R, Roider J, Birngruber R (2006) Selective retina therapy (SRT): a review on methods, techniques, preclinical and first clinical results. Bull Soc Belge Ophtalmol 302:51–69

    Google Scholar 

  18. Schuele G, Elsner H, Framme C, Roider J, Birngruber R, Brinkmann R (2005) Optoacoustic real-time dosimetry for selective retina treatment. J Biomed Opt 10:064022

    Article  PubMed  Google Scholar 

  19. Park YG, Seifert E, Roh YJ, Theisen-Kunde D, Kang S, Brinkmann R (2014) Tissue response of selective retina therapy by means of a feedback-controlled energy ramping mode. Clin Exp Ophthalmol 42:846–855

    Article  PubMed  Google Scholar 

  20. Kim HD, Han JW, Ohn YH, Brinkmann R, Park TK (2014) Functional evaluation using multifocal electroretinogram after selective retina therapy with a microsecond-pulsed laser. Invest Ophthalmol Vis Sci 56:122–131

    Article  PubMed  Google Scholar 

  21. Roider J, Liew SH, Klatt C, Elsner H, Poerksen E, Hillenkamp J, Brinkmann R, Birngruber R (2010) Selective retina therapy (SRT) for clinically significant diabetic macular edema. Graefes Arch Clin Exp Ophthalmol 248:1263–1272

    Article  PubMed  Google Scholar 

  22. Kang S, Park YG, Kim JR, Seifert E, Dirk TK, Ralf B, Roh YJ (2016) Selective retina therapy in patients with chronic central serous Chorioretinopathy: a pilot study. Medicine (Baltimore) 95:e2524

    Article  Google Scholar 

  23. Park YG, Kim JR, Kang S, Seifert E, Theisen-Kunde D, Brinkmann R, Roh YJ (2016) Safety and efficacy of selective retina therapy (SRT) for the treatment of diabetic macular edema in Korean patients. Graefes Arch Clin Exp Ophthalmol 254:1703–1713. doi:10.1007/s00417-015-3262-1

    Article  CAS  PubMed  Google Scholar 

  24. Roider J, Brinkmann R, Wirbelauer C, Laqua H, Birngruber R (2000) Subthreshold (retinal pigment epithelium) photocoagulation in macular diseases: a pilot study. Br J Ophthalmol 84:40–47

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  25. Klatt C, Saeger M, Oppermann T, Porksen E, Treumer F, Hillenkamp J, Fritzer E, Brinkmann R, Birngruber R, Roider J (2011) Selective retina therapy for acute central serous chorioretinopathy. Br J Ophthalmol 95:83–88

    Article  CAS  PubMed  Google Scholar 

  26. Elsner H, Porksen E, Klatt C, Bunse A, Theisen-Kunde D, Brinkmann R, Birngruber R, Laqua H, Roider J (2006) Selective retina therapy in patients with central serous chorioretinopathy. Graefes Arch Clin Exp Ophthalmol 244:1638–1645

    Article  CAS  PubMed  Google Scholar 

  27. Klatt C, Elsner H, Porksen E, Brinkmann R, Bunse A, Birngruber R, Roider J (2006) Selective retina therapy in central serous chorioretinopathy with detachment of the pigmentary epithelium. Ophthalmologe 103:850–855

    Article  CAS  PubMed  Google Scholar 

  28. Yasui A, Yamamoto M, Hirayama K, Shiraki K, Theisen-Kunde D, Brinkmann R, Miura Y, Kohno T (2016) Retinal sensitivity after selective retina therapy (SRT) on patients with central serous chorioretinopathy. Graefes Arch Clin Exp Ophthalmol. doi:10.1007/s00417-016-3441-8

    PubMed  Google Scholar 

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Authors and Affiliations

  1. Department of Ophthalmology and Visual Science, Yeouido St. Mary’s Hospital, Catholic University of Korea, 10,63-ro. 62, Yeongdeungpo-gu, Seoul, 07345, Republic of Korea

    Young Gun Park, Minhee Kim, Nari Yoo & Young Jung Roh

  2. Department of Ophthalmology and Visual Science, Daejeon St. Mary’s Hospital, Catholic University of Korea, 64 Daeheung-ro, Jung-gu, Daejeon, 301-012, Republic of Korea

    Seungbum Kang

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  1. Young Gun Park
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  3. Minhee Kim
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  5. Young Jung Roh
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Corresponding author

Correspondence to Young Jung Roh.

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No funding was received for this research.

Conflict of interest

All authors certify that they have no affiliations with or involvement in any organization or entity with any financial interest or non-financial interest in the subject matter or materials discussed in this manuscript.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.

Informed consent

Informed consent was obtained from all individual participants included in the study.

Financial interest

None of the authors has any financial interest in any of the products described.

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Park, Y.G., Kang, S., Kim, M. et al. Selective retina therapy with automatic real-time feedback-controlled dosimetry for chronic central serous chorioretinopathy in Korean patients. Graefes Arch Clin Exp Ophthalmol 255, 1375–1383 (2017). https://doi.org/10.1007/s00417-017-3672-3

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  • DOI: https://doi.org/10.1007/s00417-017-3672-3

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