Selective retina therapy for acute central serous chorioretinopathy

Aims To evaluate selective retina therapy (SRT) as a treatment of acute central serous chorioretinopathy. Methods 30 eyes of 30 patients with central serous chorioretinopathy of at least a 3 months' duration were recruited. 14 eyes were randomised to an SRT group (Q-switched neodymium-doped yttrium lithium fluoride (Nd:YLF) laser, wavelength 527 nm, t =1.7 mu s, energy 100-370 mu J, spot diameter 200 mu m, pulse repetition rate 100 Hz,) and 16 eyes to a control group. After 3 months of follow-up, patients in the control group with persistence of subretinal fluid (SRF) were allocated to a cross-over group, treated with SRT and followed up for further 3 months. The main outcome measures were change of best-corrected Early Treatment Diabetic Retinopathy Study visual acuity (BCVA) and SRF. Results At 3 months of follow-up, the mean (SD) improvement of BCVA was significantly greater after SRT than in the control group: 12.7 (7.2) versus 6.3 (8.9) letters (p=00.04). SRF had decreased significantly more after SRT as compared with that the control group: 203 (136) mu m versus 41 (150) mu m (p=0.005). In eight eyes allocated to the cross-over group, the mean BCVA had increased during 3 months of follow up before SRT by 1.4 (5.2) letters and continued to increase during 3 months following SRT by 7.4 (6.3) letters, while SRF increased by 39.5 (160.2) mu m before SRT and decreased by 151.5 (204.9) mu m after SRT. In six of the eight eyes, SRF had completely resolved 3 months after SRT. Conclusions SRT appears to expedite functional recovery and the re-absorption of SRF as compared with that in untreated controls. A larger prospective, randomised phase 3 confirmative patient study is warranted.