Maltsev Dmitrii S, Kulikov Alexei N, Vasiliev Alexander S, Kazak Alina A, Kalinicheva Yana A, Chhablani Jay
Department of Ophthalmology, Military Medical Academy, St. Petersburg, Russia.
UPMC Eye Center, University of Pittsburgh, Pittsburgh, PA, USA.
Curr Eye Res. 2025 Mar;50(3):304-313. doi: 10.1080/02713683.2024.2419667. Epub 2024 Oct 23.
To analyze the efficacy and safety of microsecond pulsing laser therapy (MLT) in the management of central serous chorioretinopathy (CSCR) complicated by choroidal neovascularization (CNV).
Patients with CSCR complicated by CNV defined as the presence of characteristic OCT angiography features were randomly assigned to either study or control group. All patients of the study group underwent MLT targeting CNV area using navigated laser system followed by at least 6-month follow-up. Sham treatment was performed in the control group. No other treatment or anti-VEGF therapy was used during the follow-up. Main outcome measure was complete resolution of subretinal fluid at the end of follow-up.
Twenty-three eyes (13 males and 10 females, mean age 58.2 ± 8.0 years) with a mean CNV area 0.62 ± 0.77 mm were included in the study group. Fourteen (60.9%) patients achieved complete resolution of SRF, five (21.7%) patients demonstrated some reduction of SRF, and four (17.4%) patients demonstrated no improvement after MLT in the study group. Twelve eyes (8 males and 4 females, mean age 59.8 ± 4.6 years) were included in the control group where none of them demonstrated resolution of SRF at the end of the follow-up ( = 0.0018 compared to the study group). No adverse effects, such as changes of CNV size, deterioration of exudation, or decline in visual acuity were observed in the study group.
Microsecond pulsing laser is an effective and safe option for the treatment of CSCR complicated by relatively small CNV and achieves complete resolution of SRF in 61% of cases.
分析微秒脉冲激光疗法(MLT)治疗合并脉络膜新生血管(CNV)的中心性浆液性脉络膜视网膜病变(CSCR)的疗效和安全性。
将经特征性光学相干断层扫描血管造影特征确诊为合并CNV的CSCR患者随机分为研究组和对照组。研究组所有患者使用导航激光系统针对CNV区域进行MLT治疗,随后进行至少6个月的随访。对照组进行假治疗。随访期间未使用其他治疗或抗血管内皮生长因子(VEGF)治疗。主要观察指标为随访结束时视网膜下液完全消退。
研究组纳入23只眼(男性13只,女性10只,平均年龄58.2±8.0岁),平均CNV面积为0.62±0.77mm²。研究组中,14例(60.9%)患者视网膜下液完全消退,5例(21.7%)患者视网膜下液有所减少,4例(17.4%)患者MLT治疗后无改善。对照组纳入12只眼(男性8只,女性4只,平均年龄59.8±4.6岁),随访结束时无一例视网膜下液消退(与研究组相比,P = 0.0018)。研究组未观察到如CNV大小改变、渗出恶化或视力下降等不良反应。
微秒脉冲激光是治疗合并相对较小CNV的CSCR的一种有效且安全的选择,61%的病例可实现视网膜下液完全消退。