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<p>532-nm Subthreshold Micropulse Laser for the Treatment of Chronic Central Serous Retinopathy</p>
摘要： Introduction: Subthreshold micropulse laser treatment with a 532 nm (532-SML) wavelength has been suggested as a treatment option for the treatment of chronic central serous retinopathy (cCSR). The objective is to present its effects and complications. Methods: We present a retrospective cohort study of cCSR patients submitted to 532-SML. Best-corrected visual acuity (BCVA) and spectral-domain optical coherence tomography (SD-OCT) parameters – central macular thickness, subfoveal outer nuclear layer, external limiting membrane, ellipsoid band, interdigitation band, subretinal ?uid and choroidal thickness – were evaluated before and 12 weeks after treatment. A power of 50%, a duty cycle of 5%, exposure time of 200 ms and a spot size of 160 μm were the applied laser parameters. Results: We included 26 eyes. Overall there were no signi?cant changes in visual acuity (median 0.20 (IQR 0) logMAR before and after treatment) or SD-OCT parameters. However, visual bene?ts occurred in 42.3% (n=11) of the patients and in half of the cases, subretinal ?uid was completely reabsorbed. There were no complications. Conclusion: In this study, 532-SML was overall ineffective on cCSR as it did not lead to signi?cant changes in the overall median visual acuity and SD-OCT parameters. However, some patients may have bene?ted functionally and anatomically from the treatment; further investigation is necessary to understand the potential of 532-SML.
关键词： 532 nm wavelength,subthreshold micropulse laser,outer retina bands,SD-OCT,central serous retinopathy
更新于2025-09-23 15:19:57
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Investigation of the therapeutic mechanism of subthreshold micropulse laser irradiation in retina
摘要： Purpose Subthreshold micropulse laser irradiation has been used for the treatment of retinal edema; however, there are few reports about the mechanism of its therapeutic effect. In this study, we compared threshold short pulse and subthreshold micropulse laser irradiation in mice and investigated their mechanism. Methods Nine to 12-week-old male C57BL/6J mice were used in this study. After general anesthesia, threshold short pulse or subthreshold micropulse laser irradiation was performed on the right eye using IQ577. Enucleation was performed 24 h after the laser irradiation, and histological and gene expression analyses were carried out. Results Coagulation spots and atrophy of the retinal pigment epithelium were observed after threshold short pulse laser irradiation but not after subthreshold micropulse laser irradiation. Twenty-four hours after laser, aquaporin (AQP) 1, 2, 7, and 11 levels were significantly elevated by 1.7- to 3-fold in the threshold short pulse laser group compared with non-treated control group. AQP 3 was increased significantly and prominently by 100-fold. VEGF-A and VEGFR2 were upregulated 1.5- and 2.3-fold, respectively. In the subthreshold micropulse laser group, AQP 3 was increased by 6-fold compared with the non-treated control group. Angiopoietin-1 and the adrenomedullin (AM) receptor CLR were decreased by 0.6-fold and 0.5-fold, respectively. Conclusion Threshold short pulse laser irradiation caused retinal damage and prominent changes in the expression of various genes. Contrarily, subthreshold micropulse laser irradiation did not induce retinal damage; it upregulated AQP 3, which might have improved retinal edema by drainage of subretinal fluid.
关键词： Retinal edema,Aquaporin-3,Gene expression,Subthreshold micropulse laser
更新于2025-09-19 17:13:59
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Subthreshold laser therapy for macular oedema from branch retinal vein occlusion: focused review
摘要： Retinal vein occlusion is the second- leading cause of vision loss by retinal vascular disease. Subthreshold micropulse laser therapy (SLT) is safer than conventional laser photocoagulation (CLP), yet existing reviews of its use for branch retinal vein occlusion (BRVO) are limited in scope. A literature search of PubMed, Google Scholar, Embase, Cochrane Library and ClinicalTrials.gov databases was conducted in August 2019 without restriction on language or publication date. Outcomes included changes in macular oedema (ME) and visual acuity (VA), and rates of complications or retreatments. Fourteen studies involving 315–405 eyes diagnosed with BRVO were evaluated. Treatment with SLT is associated with significant and durable reduction of ME and VA as early as 1 month. SLT performs comparably with conventional photocoagulation and intravitreal injections (IVIs) of ranibizumab. Subthreshold laser therapy is safer and as effective as CLP for the treatment of ME associated with BRVO. SLT may be used in combination with anti- VEGF IVIs to enhance improvement in VA and ME resolution.
关键词： macular oedema,visual acuity,intravitreal injections,Retinal vein occlusion,subthreshold micropulse laser therapy
更新于2025-09-19 17:13:59
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Efficacy and safety of subthreshold micropulse laser compared with threshold conventional laser in central serous chorioretinopathy
摘要： Purpose To compare the efficacy and safety of subthreshold micropulse laser (SML) with threshold conventional laser (TCL) in central serous chorioretinopathy (CSC). Methods Prospective, randomized, double-masked, non-inferiority, 12-week clinical trial. Patients were randomly assigned 1:1 to SML group or TCL group. Patients in the SML group were treated with 577 nm micropulse laser. The spot size was 160 μm, the duty cycle was 5% and exposure time was 0.2 s. The power was 50% threshold tested. Patients in the TCL group were treated with 577 nm continuous laser. The power was 100% threshold tested. The primary outcome was the mean change in best-corrected visual acuity (BCVA) at week 12, with a non-inferiority limit of five letters on the Early Treatment Diabetic Retinopathy Study (ETDRS) visual acuity charts. Results Eighty-eight patients were enroled. Seventy-seven patients were male. Forty-four patients were in SML group and 44 in TCL group. At week 12, SML was equivalent to TCL with a gain of 6.23 ± 8.59 and 6.61 ± 6.35 letters, respectively, (SML–TCL difference: ?0.38 letters; 95% confidence interval (CI):?3.58–2.81; Pnon-inferiority = 0.0026). There was no statistically significant difference between the two groups (t = 0.240, P = 0.811). At week 12, the proportion of patients whose SRF had been totally absorbed was 63.63 and 81.82% respectively for SML and TCL groups. There was no statistically significant difference between the two groups (χ2 = 3.67, P = 0.056). Conclusions Both SML and TCL can improve visual acuity in CSC. SML was non-inferior to TCL in the improvement of BCVA.
关键词： efficacy,central serous chorioretinopathy,subthreshold micropulse laser,safety,threshold conventional laser
更新于2025-09-11 14:15:04
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Transfoveal Micropulse Laser Treatment of Central Serous Chorioretinopathy within Six Months of Disease Onset
摘要： Background: It has been recommended that any invasive treatment performed in patients with central serous chorioretinopathy (CSCR) not be initiated earlier than four months after disease onset due to the potential for spontaneous remission of symptoms. The goal of this study was to examine the outcome of transfoveal subthreshold micropulse laser treatment (SMPLT) of CSCR performed at six months or less after disease onset. Materials and methods: The study included 32 cases of CSCR lasting between three weeks and six months (mean: 3.4 ± 2.3 months). All patients had transfoveal SMPLT applied and were followed for at least three months after each session of SMPLT. Two sessions of SMPLT in total were planned in case of an insu?cient response to the ?rst instance of treatment. Evaluation parameters included any change in best-corrected visual acuity (BCVA) and retinal morphology. Results: Total resolution of subretinal ?uid (SRF) was noted in 26 cases (81.25%). Final BCVA improved signi?cantly from 0.37 ± 0.22 logMAR to 0.22 ± 0.20 logMAR after treatment. Overall, early SMPLT correlated with better ?nal BCVA (p = 0.0005, Spearman rank correlation). For eyes achieving a total resolution of SRF, BCVA improved from 0.33 ± 0.21 logMAR to 0.17 ± 0.14 logMAR (p = 0.004, Spearman rank correlation). The analysis of SMPLT nonresponders revealed a tendency for poorer baseline visual acuity. Conclusions: Patients with CSCR lasting six months or less treated with transfoveal SMPLT achieve better functional results with early application of this procedure. As baseline BCVA predicts ?nal visual acuity, earlier treatment, permitted by the safety of SMPLT, may improve ?nal visual outcomes.
关键词： central serous chorioretinopathy,photodynamic therapy,subthreshold micropulse laser,subretinal ?uid
更新于2025-09-11 14:15:04