Corioretinopatia sierosa centrale cronica: nuove prospettive terapeutiche con il laser diodo micropulsato iq 577-nm, nostra iniziale esperienza

Introduction: Central Serous Chorioretinopathy (CSC) is an idiopathic disease of the outer blood retinal barrier, involving the macular region and characterized by a localized neuroepithelial detachment of the sensory retina from the retinal pigment epithelium (RPE ), sometimes associated with a serous pigment epithelium detachment (PED ) and RPE cells decompensation. CSC in the majority of cases may be self-limiting and resolve itself spontaneously or become chronic and cause visual disturbances (decreased visual acuity, metamorphopsia, altered contrast and color sensitivity). The aim of this preliminary study is to evaluate the safety and the efficacy of Subthreshold Yellow-577nm Micropulse (SYM) laser photostimulation in the treatment of patients with chronic CSC. Materials and Methods: Three eyes, one from each of three consecutive patients with chronic CSC were included in this study and treated with SYM laser photostimulation. Before treatment and at the 3, 4 and 5 month follow-up visit respectively, patients underwent a Best Corrected Visual Acuity (BCVA ) examination, dilated ophthalmoscopy, Fluorescein Angiography (FA ), and Optical Coherence Tomography (OCT ). The SYM photostimulation treatment was performed with the IQ577 semiconductor yellow laser in its MicroPulse emission mode and using the following settings: spot diameter 50 μm, mean power 520 mW, 5% duty cycle and 200 ms exposure duration. All the neuro-epithelial detachment area was treated with contiguous invisible applications with no intraoperative retinal tissue change endpoint. Results: Three men aged 48, 45 and 65 years old, with a history of chronic CSC for 8, 12 and 11 months respectively, have declining vision and metamorphopsia. After 3, 5 and 4 months after treatment with SYM, all patients recoveredtheir vision completely (BSCVA :20/20). OCT examination confirmed the resolution of the detachment of the neuroepithelium with no signs of alteration of the profile of retinal laser treatment MPD IQ-577 nm. Conclusions: The use of the LD M IQ 577-nm, specifically for EPR has proved painless, effective, safe and potentially repeatable. The ability to promote the reabsorption of subretinal fluid by stimulating the EPR at the parafoveal level, without causing damage to the retinal tissue, has opened new frontiers for the treatment of chronic CSC. If further randomized trials confirm the results of this preliminary study, the treatment SYM IQ 577-nm can be considered to be a new and important, and possibly the main, treatment option for the CSC.