Título

EARLY TREATMENT WITH MICROPULSE LASER FOR ACUTE CENTRAL SEROUS CHORIORETINOPATHY

Introdução / Purpose

To evaluate the efficacy of micropulse laser in the treatment of acute central serous chorioretinopathy (CSC) with low foveal sensitivity.

Material e Método / Methods

This was a prospective study involving six patients with acute CSC, defined by less than 30 days of symptoms, and baseline foveal sensitivity in microperimetry less than 20dB. The patients were randomized to the micropulse laser treatment group (IRIDEX IQ577®) and sham group (control with laser simulation) and evaluated in the third month of follow up. Main outcomes were visual acuity (VA) by Early Treatment Diabetic Retinopathy Study (ETDRS), foveal sensitivity by microperimetry (MAIA, Centervue ®) and subfoveal retinal and choroidal thickness by optical coherence tomography (OCT) (DRI OCT, Triton ®).

Resultados / Results

At the end of 3 months of follow-up, the treatment group gained 25.33 ± 2.31 letters and the sham group 1.33 ± 7.64. The difference in visual improvement between the groups was statistically significant (p=0.046). The foveal sensitivity also showed improvement with statistical significance (20.33 ± 2.08dB) compared to the sham group (6.33 ± 4.51dB), p=0.049. The treatment group had a statistically significant reduction of foveal thickness of 449.67 ± 130.22μm, while the sham group had an increase of 26.67 ± 62.04μm, p=0.049. The choroid thickness did not demonstrate a significant change at any point in the study.

Discussão e Conclusões / Discussion

Early treatment with micropulse laser in patients with low initial foveal sensitivity, and therefore more risk to develop chronic serous detachment, showed a better outcome in visual acuity, foveal sensitivity and foveal thickness when compared to the sham group. The choroidal thickness showed no significant change during the follow up. Early treatment of patients with acute CSC and microperimetry less than 20DB was beneficial in this study when compared to placebo group.

Palavras Chave

acute central serous chorioretinopathy; micropulse; microperimetry; retinal thickness; choroidal thickness