Abstract:

Objective To observe the efficacy of the subthreshold micropulse yellow laser（577 nm）for chronic central serous chorioretinopathy (CSC) and its effects on macular pigment. Design Retrospective cases series. Participants 32 eyes of 32 patients with chronic CSC treated with subthreshold micropulse yellow laser photocoagulation were enrolled. Method All patients were examined with best corrected visual acuity (BCVA), color fundus photography，fundus fluorescein angiography(FFA) combined with indocyanine green angiography(ICGA)，optical cohenrence tomography (OCT) and contrast sensitivity. Subthreshold micropulse yellow laser was performed in the micropulse mode, using 100 μm spot diameter and 0.2 s duration with 5% duty cycle, and power reduced 50% from the power of a single threshold burn. Micropulse yellow laser was applied on the leaking point on fluorescein angiogram and normal retina around the borderline area of serous retinal detachmen (50～100 μm). Retreatment was considered in clinic examination which was the same with that of baseline. Main outcome measures BCVA, centrel fovea thickness (CFT), contrast sensitivity, the rate of resolution of subretinal fluid (SRF), MPOD, and the factors associated with prognosis. Results The average BCVA was 0.36±0.15, 0.35±0.16, 0.32±.021 at 1th，3th，6th month respectively, significantly better than at baseline (all P<0.05). The average CFT was (305.56±62.53) μm, (298.29±46.42) μm, (253.81±57.18) μm reapectively, significantly decreased than at baseline (all P<0.05). The average contrast sensitivity was 14.32±1.02, 15.68±0.98, 17.53±1.32 respectively, significantly better than at baseline (all P<0.05). The rate of resolution of SRF was 100% in chronic CSC patients with point source leakage. The rate of resolution of SRF was 72.73% in chronic CSC patients with point source leakage and associated RPE atrophy. The rate of resolution of SRF was 64.25% in chronic CSC patients with diffuse RPE decompensation. Ages in nonresponder group was higher than that in responder group (t=-9.23，P=0.001). At 6 months，any structural laser damage were not showed. The average MPOD after treatment remained at the baseline level (all P>0.05). Conclusion Subthreshold micropulse yellow laser (577 nm) photocoagulation treatment is an effective and safe treatment option for patients with chronic CSC. The MPOD did not increased after subthreshold micropulse yellow laser (577 nm) photocoagulation.

Key words: chronic central serous chorioretinopathy, subthreshold micropulse laser photocoagulation；macular pigment optical density