Level of the impact necessary for obtaining clinical results in patients with acute central serous chorioretinopathy using the technology of selective micropulse individual retinal therapy (SMIRT)

Purpose. To determine which is the level of probability of damage detection (PDD) by shortwave autofl uorescence (AF) to achieve clinical results in the treatment of central serous chorioretinopathy (CSCR) using the technology of selective micropulse individual retinal therapy (SMIRT).

Material and methods. 83 patients (83 eyes) with acute CSCR, aged 30–65, type 1–4 by the Fitzpatrick scale, were under the observation. Patients were divided into four groups. Selective micropulse mode without preliminary testing on Iridex IQ 577 laser system (50–150 μs, 0.5–5 %, 10–50 ms (1–5 pulses), 1.0–2.0 W, 100 μm) was used to treat CSCR in patients from Groups 1, 2 and 3. Parameters to predict the effective PDD levels by AF data were calculated using formulas taking into account patient’s age and type of appearance. In Group 1, parameters for treatment that corresponded to PDD level equal to 50 % were used; in Group 2 – to PDD level of 70 %, and in Group 3 – to PDD level of 90 %. Laser spots were applied close to each other, completely covering detachment areas and RPE defects. In Group 4 (controls), no CSCR treatment was performed.

Results. In Group 1, one month after the treatment complete resorption of subretinal fl uid (SF) was seen in 3 eyes (16.67 %), and three months later – in 7 eyes (38.89 %) (p < 0.29). In Group 2, in one month complete SF resorption was observed in 8 eyes (38.1 %), and in three months – in 13 patients (61.9 %) (p < 0.011). In Group 3, complete SF resorption was observed in 17 patients (70.83 %) in one month after laser treatment, and three months later – in 22 patients (91.67 %) (p < 0.0008). In the control group, during one month follow-up, complete SF resorption was seen in 2 patients (10 %), and during 3-month follow-up – in 4 patients (20 %).

Conclusion. High clinical effectiveness of CSCR treatment with SMIRT technology is achieved when using parameters that correspond to PDD level by AF data of 90 %.

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