Título / Title

THE CONTROVERSY OF SUBTHRESHOLD MICROPULSED LASER. WHAT’S THE BEST WAY TO DO IT?

Introdução / Purpose

Central Serous Chorioretinopathy (CSC) affects preferably young male individuals with unilateral change in vision, from mild to moderate, in recurrent crises. The aim of the study is to evaluate and compare the parameters and strategies of subthreshold micropulsed laser in the treatment of CSC

Material e Método / Methods

Prospective case series of 15 eyes of 14 patients with chronic CSC treated with subthreshold micropulsed laser. The treatment was performed using two types of parameters in SubLiminal Laser. For the first group: 5% DC, 160um spot size, 0,2sec exposure time and titration of the laser power. For the second group we used parameters described by Luttrull et al.: 5% DC, 500um spot size, 0,3 sec of exposure time and fixed power of 425mW. For each patient, the treatment parameters and anatomical improvements (resolution of sub retinal fluid and central macular thickness) were evaluated.

Resultados / Results

15 eyes of 14 patients were included (80% male, mean age 45 years old, range 35-77). Although a larger range of parameter sets, no patient demonstrated adverse events from micropulsed laser. Mean laser power in the first group was 370mW (range 250-500mW) and mean number of spots was 630 (range 400-930). For the first group that included 8 eyes, in 87,5% of the eyes we observed reduction of subretinal fluid. In the second group, that included 7 eyes, we observed in 85,72% of the eyes improvement of subretinal fluid. In the one patient without response to the treatment in one eye, it was necessary to perform treatment with a thermal focal laser and the fluid improved after this procedure.

Discussão e Conclusões / Conclusion

This presentation describes partial results from an ongoing study, further studies are necessary to determinate the best parameters for the use of subthreshold micropulsed laser. . Macular thickness, improvement of subretinal fluid in this study exhibited slightly better response with the parameters of the first group, in which the laser power was titrated, suggesting the need of more studies and longer follow-up.

Palavras Chave

central serous chorioretinopathy, laser, micropulse laser, laser photocoagulation

Area

CLINICAL RETINA