Subliminal Laser Therapy is a Macular treatment
A macular treatment
SubLiminal laser therapy is currently most commonly used in cases of retinal vascular diseases with macular edema, such as diabetic macular edema (DME) or central serous chorioretinopathy (CSR).
Other macular pathologies can also be considered like macular edema secondary to branch retinal vein occlusion (BRVO) or polypoidal choroidal vasculopathy (PCV).
SubLiminal laser therapy is a method of delivering laser energy to the retina, producing a bio-stimulation effect, while minimizing permanent thermal damage to the retinal tissue. The concept involves delivery of a “train” of laser pulses, each pulse separated by sufficient time to allow heat dissipation and reduce permanent damage to the retina. Unlike conventional macular laser treatment, there is no visible scarring on clinical examination, OCT or angiogram.
Refer below to the recommended SubLiminal laser treatment guidelines prepared by Victor Chong, MD (UK).
Retina Treatment: Subliminal Treatment Procedure
Basic Principles of MicroPulse Lasers
Central Serous Chorioretinopathy (CSC)
Central serous chorioretinopathy (CSC) 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 CSC, the detachment is caused by a focal leak in the RPE. It usually resolves spontaneously within a few weeks3. However, chronic CSC 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 CSC7:
- Traditional thermal photocoagulation can be used for extrafoveal leakages, but it is destructive and can lead to symptomatic scotomas and choroidal neovascularization.
- PDT laser therapy can also be used, however, even when using reduced treatment settings; it has also number of side effects such as RPE atrophy, choroidal neovascularization, choriocapillaris ischemia, and transient reduction of macular function.
- Yellow 577nm SubLiminal® laser therapy seems to be a promising alternative treatment strategy8.
Images courtesy of Alejandro Filloy Rius, MD. Ph.D