| CSCR | DME | Other pathologies |
> CSCRCentral serous chorioretinopathy (CSCR) is one of the most common retinal causes of vision loss. It is characterized by serous detachment of the neurosensory retina secondary to one or more focal lesions of the retinal pigment epithelium (RPE)1. This pathology ranks among the most common vision-threatening retinopathies after AMD, diabetic retinopathy and branch retinal vein occlusion2. In acute CSCR, the detachment is caused by a focal leak in the RPE. It usually resolves spontaneously within a few weeks3. However, chronic CSCR can lead to permanent structural damage and often pronounced loss of central vision456. Different treatment options are available, but there is no “gold standard” treatment for chronic CSCR7:
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SubLiminal laser for the treatment of CSCR
Paula Scholz, MD
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Yellow subthreshold laser for Acute CSCR To compare the efficacy of 50% threshold power with 25% threshold power of 577-nm subthreshold micropulse laser (SMPL) for acute central serous chorioretinopathy (CSC). Prospective, interventional, non-randomized, comparative case series. By Lijun Zhou, Victor Chong, Kunbei Lai, Chuangxin Huang, Fabao Xu, Yajun Gong, Maimaitiaili Youlidaxi, Tao Li, Lin Lu, Chenjin Jin |
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SubLiminal Laser Therapy for Central Serous Chorioretinopathy Central Serous Chorioretinopathy (CSC) is a challenging disease with causes that are still not fully understood. By Paula Scholz, MD |
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Micropulse Laser Treatment of Retinal Diseases A modern theory of micropulse laser interaction with retinal tissue and a possible explanation of this mechanism are presented in this review. The authors present all the relevant literature on the application of micropulse lasers in different retinal disorders. The efficacy of this treatment is analyzed on the basis of available studies and then placed in the perspective of other therapeutic methods that are used in retinal diseases. By Maciej Gaw˛ecki |
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Subthreshold Micropulse Laser (577 nm) Treatment in Chronic Central Serous Chorioretinopathy To assess treatment with a 577-nm subthreshold micropulse laser (SML) in patients with chronic central serous chorioretinopathy (cCSC). By Paula Scholz, MD |
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A review of Subthreshold Micropulse Laser for Treatment of Macular Disorders Micropulse laser treatment is an alternative to the conventional continuous-wave laser for the treatment of retinal or macular diseases. By Paula Scholz, MD |
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SubLiminal Subthreshold Laser Versus Photodynamic Therapy Yellow SubLiminal laser has a more beneficial effect on visual acuity compared with half-dose photodynamic therapy. By Lihteh Wu, MD |
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Introduction to MicroPulse for Central Serous Chorioretinopathy MicroPulse laser has become one of our hospital's standard treatments for CSCR. By Sascha Fauser, MD |
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> DMEDiabetic retinopathy is the leading cause of visual loss and blindness in working age populations in the developed world. Diabetic macular edema (DME) is the leading cause of blindness in the diabetic population. A recent pooled analysis from 35 population-based studies estimated that 93 million people worldwide have diabetic retinopathy, of whom 17 million (~18%) have proliferative DR, 21 million (~23%) have diabetic macular edema (DME), and 28 million (~20%) have sight-threatening DR9. The treatment of DME has changed significantly in the past years. Nevertheless the best treatment option applicable to all DME patients still remains an open question. Although the introduction of anti-VEGF therapies has shown its safety and efficacy, the laser still plays an important role1011. Yellow 577nm SubLiminal® laser therapy can be an excellent adjunct or alternative to anti-VEGF therapies.
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Our first year of lessons learnt with SubLiminal laser for CCSC and DME
Alejandro Filloy, MD
| Comparison of 577-nm Multispot and Standard Single-Spot Photocoagulation for Diabetic Retinopathy Objective: To compare two different laser strategies of panretinal photocoagulation for diabetic retinopathy. By Renato M. Passos, José Belucio-Neto, Camilla O. Xavier, Eduardo A. Novais, Mauricio Maia, Michel Eid Farah |
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| A review of Subthreshold Micropulse Laser for Treatment of Macular Disorders Micropulse laser treatment is an alternative to the conventional continuous-wave laser for the treatment of retinal or macular diseases. By Paula Scholz, MD |
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| Laser Remains An Effective Treatment option for DME The 577 nm SubLiminal laser is a safe and cost-effective option for treatment of diabetic macular edema anc central serous retinopathy.By Kenneth Fong, MD |
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| Current Role for Laser to Treat DME Laser photocoagulation has been the mainstay of treatment for diabetic macular edema (DME), but the introduction of the anti-VEGF drugs have led some to think laser is no longer an appropriate option...By Victor Chong, MD |
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> Other pathologies
– IPCV
Idiopathic Polypoidal choroidal vasculopathy (IPCV) is a disease of the choroidal vasculature.
It is characterised by the presence of aneurysmal polypoidal lesions and branching vascular network, in the choroidal vasculature. This can lead to serous or haemorrhagic pigment epithelial detachment (PED), episodes of exudative retinal detachment and subretinal exudation and haemorrhage.
It is considered a variant of neovascular AMD.
IPCV is a relatively common in Asian and African American populations, affecting both sexes .
Evidence supports that:
- Symptomatic patients with IPCV can have complete regression without severe vision loss with photodynamic therapy (PDT) and anti-VEGF treatment.
- 577nm SubLiminal laser can be used to supplement treatment in IPCV cases with suboptimal response to anti-VEGF treatment.
Efficacy of SubLiminal laser in IPCV Aflibercept resistant cases
Saad Younis, MD
– AMD
Age-related macular degeneration is the world’s leading cause of irreversible blindness among elderly people.
Atrophic AMD (Dry AMD) affects approximately 80-90% of individuals with AMD.
In early AMD, small white or yellowish deposits, called drusen, form on the retina, beneath the macula, causing it to deteriorate or degenerate over time.
Hard drusen are small, well-demarcated lesions and can be seen in the healthy, aging population.
Soft drusen are large and there borders are less well defined (cotton-ball’ like). They are generally pathologic and are not found in young, healthy populations.
There is currently no treatment for drusen, nevertheless it has been observed clinically that subthreshold laser could make drusen disappear and prevent the progression of the pathology.
Clinical studies are currently ongoing regarding this topic.
SubLiminal laser in macular diseases
Victor Chong, MD
> Clinical References
- Central serous chorioretinopathy: A review of epidemiology and pathophysiology.
Gerald Liew MBBS PhD, Godfrey Quin Franzco PhD, Mark Gillies Franzco PhD and Samantha Fraser-Bell Franzco PhD (Save Sight Institute, and Centre for Vision Research, University of Sydney, Sydney Australia) - Central serous chorioretinopathy Acta Ophthalmol., 86 (2008), pp. 126–145 Wang et al., 2008 M. Wang, I.C. Munch, P.W. Hasler, C. Prünte, M. Larsen
- Experience with nontreatment of central serous choroidopathy.
Arch Ophthalmol 1974; 91: 247–250. Klein ML, Van Buskirk EM, Friedman E, Gragoudas E, Chandra S - Long-term follow-up of central serous chorioretinopathy.
Br J Ophthalmol 1984; 68:815–820.Gilbert CM, Owens SL, Smith PD, Fine SL - Longterm follow-up of a prospective trial of argon laser photocoagulation in the treatment of central serous retinopathy.
Br J Ophthalmol 1988; 72: 829–834. Ficker L, Vafidis G, While A, Leaver P - Risk factors for recurrence of serous macular detachment in untreated patients with central serous chorioretinopathy.
Ophthalmic Res 2011; 46:160–163. Fok AC, Chan PP, Lam DS, Lai TY. - SubLiminal® Micropulse Laser (577 nm) Treatment in Chronic Central Serous Chorioretinopathy.
Paula Scholz, Lebriz Ersoy, Camiel J.F. Boon, Sascha Fauser; Department of Ophthalmology, University Hospital of Cologne, Cologne , Germany; b Leiden University Medical Center, Leiden , The Netherlands - SubLiminal® Micropulse Laser (577 nm) Treatment in Chronic Central Serous Chorioretinopathy.
Paula Scholz, Lebriz Ersoy, Camiel J.F. Boon, Sascha Fauser; Department of Ophthalmology, University Hospital of Cologne, Cologne , Germany; b Leiden University Medical Center, Leiden , The Netherlands - Global Prevalence and Major Risk Factors of Diabetic Retinopathy.
Diabetes care 2012 10.2337/dc11-1909 – Yau JW, Rogers SL, Kawasaki R, et al. - SubLiminal® Micropulse Laser Therapy for Retinal Disorders.
Retina Today – Christine Kiire, MD; Sobha Sivaprasad, MD; and Victor Chong, MD - The Short-term Efficacy of SubLiminal® Micropulse Yellow (577-nm) Laser Photocoagulation for Diabetic Macular Edema.
Korean J Ophthalmol. 2014 Oct;28(5):379-85. doi: 10.3341/kjo.2014.28.5.379. Epub 2014 Sep 18. Kwon YH, Lee DK, Kwon OW.
