Ivan Fiser
Lexum European Eye Clinic, Czech Republic
Title: Stimulation laser in cetral serous chorioretinopathy
Biography
Biography: Ivan Fiser
Abstract
Background: Central serous chorioretinopathy is easy to treat when the focus of leakage is obvious; however, in diffuse leakage the treatment is unknown. We use an individualized treatment for CSC based both on traditional procedures and on experimental ones. Laser stimulation therapy can be beneficial even in cases without the typical focus of leakage.
Methods: A group of 88 patients with diagnosed CSC included various, very different findings. We excluded 20 eyes which healed spontaneously within several months and also five eyes where the finding was questionable and it reminded AMD. We treated 30 eyes where the focus was clearly defined with focal laser, even in eyes where the focus was juxtafoveal. Here, we used threshold energy. In nine eyes in which the focus could not be clearly defined, we used threshold or sub-threshold laser into the anticipated focus. In 13 eyes with multiple leakage or diffuse leakage, we used a “stimulation laser” in the areas of leakage, believing in the activation of the RPE leading to the sealing of the area of leakage. In six cases, we first tried topical steroid drops in an intensive mode of application, i.e. every hour within one to two weeks, or Avastin, Triamcinolone, or Eylea injections.
Results: The laser treatment was followed with a complete recovery not only in cases of focal treatment of the leakage point but also in the eyes with very chronic (even lasting seven years) leakage from undefined site. Steroid drops as a mono-therapy also helped with healing of two patients but neither Avastin nor Eylea and Triamcinolone did not bring a convincing effect.
Take home message: CSC can be treated with laser not only in cases with clearly focal leakage but even in cases with poorly defined, only anticipated or diffuse leakage.