Título

THE CONTROVERSY OF SUBTHRESHOLD MICROPULSED LASER. WHAT’S THE BEST WAY TO DO IT?

Objetivo

Central Serous Chorioretinopathy (CSC) affects preferably male individuals, from the second to the fourth decade of life, with unilateral change in vision, from mild to moderate, in recurrent crises. It is estimated to represent one of the four most common diseases in clinical practice, along with age-related macular degeneration.The aim of the study is to evaluate and compare the parameters and strategies for the use of subthreshold micropulsed laser in the treatment o CSC.

Método

Prospective case series of 14 eyes of 13 patients with chronic CSC treated with subthreshold micropulsed laser. The treatment was performed using two types of parameters in SubLiminal Laser. For the first group: 5% duty cycle, 160um spot size, 0,2 sec of exposure time and titraton of the laser power. For the second group we used parameters described by Luttrull et al. : 5% of duty cycle, 500um spot size, 0,3 sec of exposure time and fixed power of 425mW. For each patient, the treatment parameters and anatomical improvements (resolution of sub retinal liquid and central macular thickness) were evaluated.

Resultado

14 eyes of 13 patients were included (84,61% male patients, mean age 42 years old with the range of 35-64). Although a larger range of parameter sets, no patient demonstrated adverse events from micropulsed laser. Mean laser power in the first group was 345mW (range of 250-500mW) and mean number of spots was 630 (range of 400-930). For the first group that included 7 eyes, in 71,42% of the eyes we observed reduction of subretinal fluid. In the second group, that included 7 eyes, using the parameters described by Luttrull et al. we observed also 71,42% of the eyes improvement of subretinal fluid.

Conclusão

This presentation describes partial results from an ongoing study, further studies are necessary to determinate the best parameters for the use of subthreshold micro pulsed laser. Macular thickness, improvement of subretinal fluid in this study exhibited similar response with the parameters of both groups, suggesting the need of more studies and longer follow-up.