Evaluation of the Safety and Efficacy of Selective Retina Therapy Laser Treatment in Patients with Central Serous Chorioretinopathy

초록

Purpose: To assess the safety and efficacy of selective retina therapy (SRT) using a Q-switched neodymium-doped yttriumlithium fluoride laser with feedback systems in patients with idiopathic central serous chorioretinopathy (CSC). Methods: This randomized clinical trial enrolled patients having at least 3-month symptom of CSC. From month 3 visit, allsubjects in both groups were eligible for SRT retreatment if they showed persistent or recurrent subretinal fluid (SRF). The primaryoutcome was complete resolution of SRF by optical coherence tomography at 3 months after treatment. The secondaryoutcomes were changes in SRF, central macular thickness (CMT) and best-corrected visual acuity at the 1-, 3-, and 6-monthexaminations. Results: Sixty-eight CSC patients were included (SRT, 31; control, 37). After 1 and 3 months, complete resolution of SRF wasachieved in 25.8% and 54.8% of SRT group and 17.6% and 35.1% of controls. The differences were not statistically significant(p = 0.424 and p = 0.142, respectively). However, mixed model for repeated measures analyses showed that the reduction ofSRF and CMT were observed earlier in SRT group than in the sham group (least squares mean difference, -59.7 μm; 95% confidenceinterval, -98.2 to -21.2; p = 0.0029; least squares mean difference -67.0 μm; 95% confidence interval, -104.8 to -29.2;p = 0.0007, respectively). Significant reduction of SRF (≥50% reduction from baseline) was more frequently observed in SRTgroup (80.6%) than the sham group (44.1%) at month 1 (p = 0.007). Early reduction of SRF and CMT was more abundant inSRT group with symptom duration less than 6 months. Treatment related serious adverse events were not observed. Conclusions: SRT using a Q-switched neodymium-doped yttrium lithium fluoride laser with feedback system was safe in thistrial and effective for early resolution of SRF in the CSC patients. Early intervention with SRT can be a safe alternative for patientswith acute symptomatic CSC.

키워드