Observation of the curative effect of targeted navigation laser with continuous wave power under the threshold in the treatment of chronic central serous chorioretinopathy_Chinese Journal of Ocular Fundus Diseases

Authors：

Zhao Yue , Zhang Su , Zang Xiao , Jiang Qin ,  Yao Jin

Nanjing Medical University Eye Hospital, Nanjing 210000, China;

Corresponding author：

Yao Jin, Email: dryaojin@126.com

Keywords：

Central serous chorioretinopathy; Laser coagulation; Navigated laser; Sub-threshold continuous wave

DOI：

10.3760/cma.j.cn511434-20201222-00630

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Objective To observe the safety and effectiveness of targeted navigation laser with continuous wave threshold power in the treatment of chronic central serous chorioretinopathy (CCSC).Methods A retrospective clinical study. From November 2018 to June 2020, 28 eyes of 28 patients with CCSC diagnosed in the Eye Hospital of Nanjing Medical University were included in the study. Among them, there were 17 males with 17 eyes and 11 females with 11 eyes; all of them had a monocular disease. The average age of the patients was 36.24±5.14 years, and the average course of the diseases was 4.7±1.3 months. All affected eyes underwent best corrected visual acuity (BCVA), fluorescein fundus angiography, fundus autofluorescence, frequency domain optical coherence tomography and angiography, multifocal electroretinogram (mf-ERG) and micro field inspection. BCVA was carried out using the international standard visual acuity chart, which was converted into the logarithmic minimum angle of resolution (logMAR) visual acuity during statistics. A targeted navigation laser system was used for continuous wave power therapy under the threshold. Two weeks and 1, 3 months after treatment, the same equipment and methods as before treatment were used to perform related examinations to observe the BCVA, subfoveal choroidal thickness (SFCT), foveal retinal thickness (CMT), the mean light sensitivity (MS) in the 10° range of the macular center, and the amplitude density of P₁waveat ring 1 and 2. The t test was used to compare CMT, SFCT, retinal amplitude density and MS before and after treatment.Results Before treatment and 2 weeks, 1 and 3 months after treatment, the average logMAR BCVA of the eyes were 0.74±0.16, 0.57±0.16, 0.22±0.05, 0.21±0.06, and the average CMT was 512.33±31.56, 350.40±36.61, 256.49±22.38, 253.45±23.65 μm respectively, the average SFCT was 462.82±25.38, 462.37±39.54, 461.51±29.36, 461.25±34.55 μm, the average MS was 16.32±5.41, 17.53±4.23, 19.52±4.12, 21.35±2.77 dB respectively. At different times before and after treatment, BCVA (t=6.52, 5.71, 6.01; P=0.00, 0.00, 0.00), CMT (t=3.08, 6.57, 4.90; P=0.01, 0.00, 0.00), SFCT (t=7.01, 6.54, 4.85; P=0.08, 0.07, 0.17), MS (t=6.17, 4.25, 5.46; P=0.02, 0.00, 0.00), the difference was statistically significant. The amplitude density of P₁wave at ring 1 in the affected eye was 64.37±18.25, 85.31±13.98, 98.35±14.52, 98.40±22.17 nV/deg², and the amplitude density of P₁wave at ring2 was 36.12±18.32, 44.02±17.15, 62.35±14.85, 63.17±15.79 nV/deg². The amplitude density of P₁wave at ring 1 (t=5.11, 9.03, 4.27; P=0.03, 0.00, 0.00) and ring 2 (t=5.11, 9.03, 4.27; P=0.03, 0.00, 0.00) before and after treatment showed statistical significance.Conclusion Targeted navigation laser continuous wave threshold power treatment for CCSC can increase the BCVA, macular retinal amplitude density and macular foveal MS, and reduce CMT and SFCT.

Citation： Zhao Yue, Zhang Su, Zang Xiao, Jiang Qin, Yao Jin. Observation of the curative effect of targeted navigation laser with continuous wave power under the threshold in the treatment of chronic central serous chorioretinopathy. Chinese Journal of Ocular Fundus Diseases, 2021, 37(8): 599-604. doi: 10.3760/cma.j.cn511434-20201222-00630 Copy

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8.	姚亮, 吕莎莎, 刘子瑶, 等. 康柏西普治疗慢性中心性浆液性脉络膜视网膜病变的疗效[J]. 国际眼科杂志, 2017, 17(6): 1139-1142. DOI: 10.3980/j.issn.1672-5123.2017.6.34.Yao L, Lyu SS, Liu ZY, et al. Observation on the efficacy of Conbercept for chronic central serous chorioretinopathy[J]. Int Eye Sci, 2017, 17(6): 1139-1142. DOI: 10.3980/j.issn.1672-5123.2017.6.34.
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10.	Yannuzzi LA. Central serous chorioretinopathy: a personal perspective[J]. Am J Ophthalmol, 2010, 149(3): 361-363. DOI: 10.1016/j.ajo.2009.11.017.
11.	刘松涛, 蒋乐文, 高亮, 等. 雷珠单抗治疗慢性中心性浆液性脉络膜视网膜病变的临床效果观察[J]. 河南医学研究, 2018, 22(27): 4062-4065. DOI: 10.3969/j.issn.1004-437X.2018.22.011.Liu ST, Jiang LW, Gao L, et al. Clinical observation of ranibizumab in the treatment of chronic central serous chorioretinopathy[J]. Henan Medical Research, 2018, 22(27): 4062-4065. DOI: 10.3969/j.issn.1004-437X.2018.22.011.
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17.	王康孙. 眼底病治疗[M]//王康孙. 眼科激光基础与临床. 上海: 上海科技教育出版社, 2008: 307-325.Wang KS. Treatment of fundus diseases[M]//Wang KS. Fundamentals and clinical applications of ophthalmic laser. Shanghai: Shanghai Science and Technology Education Press, 2008: 307-325.
18.	邵东平, 丁瑛, 刘斐, 等. 阈值下激光光凝治疗糖尿病性黄斑水肿的临床效果[J]. 国际眼科杂志, 2013, 13(7): 1391-1394. DOI: 10.3980/j.issn.1672-5123.2013.07.28.Shao DP, Ding Y, Liu F, et al. Clinical effect of subthreshold photocoagulation for diabetic macular edema using 532 laser[J]. Int Eye Sci, 2013, 13(7): 1391-1394. DOI: 10.3980/j.issn.1672-5123.2013.07.28.

1. Liew G, Quin G, Gillies M, et al. Central serous chorioretinopathy: a review of epidemiology and pathophysiology[J]. Clin Exp Ophthalmol, 2013, 41(2): 201-214. DOI: 10.1111/j.1442-9071.2012.02848.x.
2. Gemenetzi M, De Salvo G, Lotery AJ. Central serous chorioretinopathy: an update on pathogenesis and treatment[J]. Eye (Lond), 2010, 24(12): 1743-1756. DOI: 10.1038/eye.2010.130.
3. Daruich A, Matet A, Dirani A, et al. Central serous chorioretinopathy: recent findings and new physiopathology hypothesis[J]. Prog Retin Eye Res, 2015, 48: 82-118. DOI: 10.1016/j.preteyeres.2015.05.003.
4. 何吕福, 王晓华, 温旭. 脉络膜厚度研究进展[J]. 中华实验眼科杂志, 2017, 35(10): 949-954. DOI: 10.3760/cma.j.issn.2095-0160.2017.10.021.He LF, Wang XH, Wen X. Review on progress of choroidal thickness[J]. Chin J Exp Ophthalmol, 2017, 35(10): 949-954. DOI: 10.3760/cma.j.issn.2095-0160.2017.10.021.
5. Schatz H, Madeira D, Johnson RN, et al. Central serous chorioretinopathy occurring in patients 60 years of age and older[J]. Ophthalmology, 1992, 99(1): 63-67. DOI: 10.1016/S0161-6420(92)32010-X.
6. Hussain D, Gass JD. Idiopathic central serous chorioretinopathy[J]. Indian J Ophthalmol, 1998, 46(3): 131-137.
7. Takkar B, Azad S, Sodhi PS. Loculation of fluid in the posterior choroid in eyes with central serous chorioretinopathy[J]. Am J Ophthalmol, 2016, 163: 194-195. DOI: 10.1016/j.ajo.2015.12.018.
8. 姚亮, 吕莎莎, 刘子瑶, 等. 康柏西普治疗慢性中心性浆液性脉络膜视网膜病变的疗效[J]. 国际眼科杂志, 2017, 17(6): 1139-1142. DOI: 10.3980/j.issn.1672-5123.2017.6.34.Yao L, Lyu SS, Liu ZY, et al. Observation on the efficacy of Conbercept for chronic central serous chorioretinopathy[J]. Int Eye Sci, 2017, 17(6): 1139-1142. DOI: 10.3980/j.issn.1672-5123.2017.6.34.
9. Chan WM, Lai TY, Lai RY, et al. Safety enhanced photodynamic therapy for chronic central serous chorioretinopathy: one-year results of a prospective study[J]. Retina, 2008, 28(1): 85-93. DOI: 10.1097/IAE.0b013e318156777f.
10. Yannuzzi LA. Central serous chorioretinopathy: a personal perspective[J]. Am J Ophthalmol, 2010, 149(3): 361-363. DOI: 10.1016/j.ajo.2009.11.017.
11. 刘松涛, 蒋乐文, 高亮, 等. 雷珠单抗治疗慢性中心性浆液性脉络膜视网膜病变的临床效果观察[J]. 河南医学研究, 2018, 22(27): 4062-4065. DOI: 10.3969/j.issn.1004-437X.2018.22.011.Liu ST, Jiang LW, Gao L, et al. Clinical observation of ranibizumab in the treatment of chronic central serous chorioretinopathy[J]. Henan Medical Research, 2018, 22(27): 4062-4065. DOI: 10.3969/j.issn.1004-437X.2018.22.011.
12. Kernt M, Cheuteu R, Vounotrypidis E, et al. Focal and panretinal photocoagulation with a navigated laser(NAVILAS®)[J/OL]. Acta Ophthalmol, 2011, 89: e662-e664[2011-10-14]. https://pubmed.ncbi.nlm.nih.gov/20946326/. DOI: 10.1111/j.1755-3768.2010.02017.x.
13. Leaver P, Williams C. Argon laser photocoagulation in the treatment of central serous retinopathy[J]. Br J Ophthalmol, 1979, 63: 674-677. DOI: 10.1136/bjo.63.10.674.
14. Roisman L, Magalhães FP, Lavinsky D, et al. Micropulse diode laser treatment for chronic central serous chorioretinopathy: a randomized pilot trial[J]. Ophthalmic Surg Lasers Imaging Retina, 2013, 44: 465-470. DOI: 10.3928/23258160-20130909-08.
15. 陈文文, 常青. 玻璃体腔内注射抗血管内皮生长因子药物的全身不良反应[J]. 中国眼耳鼻喉科杂志, 2016, 16(2): 130-134. DOI: 10.14166/j.issn.1671-2420.2016.02.020.Chen WW, Chang Q. Systemic adverse event of intravitreal anti-vascular endothelial growth factor drugs[J]. Chin J Ophthalmol and Otorhinolaryngol, 2016, 16(2): 130-134. DOI: 10.14166/j.issn.1671-2420.2016.02.020.
16. 徐建峰, 杨丽君, 莫荔, 等. 真实世界下玻璃体腔内注射抗VEGF药物治疗眼底疾病的实效性研究[J]. 国际眼科杂志, 2017, 17(9): 1734-1737. DOI: 10.3980/j.issn.1672-5123.2017.9.33.Xu JF, Yang LJ, Mo L, et al. Effective study in the real-world study of intravitreal anti-VEGF drugs injection in the treatment of fundus diseases[J]. Int Eye Sci, 2017, 17(9): 1734-1737. DOI: 10.3980/j.issn.1672-5123.2017.9.33.
17. 王康孙. 眼底病治疗[M]//王康孙. 眼科激光基础与临床. 上海: 上海科技教育出版社, 2008: 307-325.Wang KS. Treatment of fundus diseases[M]//Wang KS. Fundamentals and clinical applications of ophthalmic laser. Shanghai: Shanghai Science and Technology Education Press, 2008: 307-325.
18. 邵东平, 丁瑛, 刘斐, 等. 阈值下激光光凝治疗糖尿病性黄斑水肿的临床效果[J]. 国际眼科杂志, 2013, 13(7): 1391-1394. DOI: 10.3980/j.issn.1672-5123.2013.07.28.Shao DP, Ding Y, Liu F, et al. Clinical effect of subthreshold photocoagulation for diabetic macular edema using 532 laser[J]. Int Eye Sci, 2013, 13(7): 1391-1394. DOI: 10.3980/j.issn.1672-5123.2013.07.28.

Chinese Journal of Ocular Fundus Diseases

Observation of the curative effect of targeted navigation laser with continuous wave power under the threshold in the treatment of chronic central serous chorioretinopathy

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