PMID- 33205239
OWN - NLM
STAT- MEDLINE
DCOM- 20210818
LR  - 20240402
IS  - 1435-702X (Electronic)
IS  - 0721-832X (Print)
IS  - 0721-832X (Linking)
VI  - 259
IP  - 6
DP  - 2021 Jun
TI  - Selective retina therapy (SRT) in patients with therapy refractory persistent 
      acute central serous chorioretinopathy (CSC): 3 months functional and 
      morphological results.
PG  - 1401-1410
LID - 10.1007/s00417-020-04999-9 [doi]
AB  - PURPOSE: Central serous chorioretinopathy (CSC) is a disease presenting with 
      detachment of the neurosensory retina and characteristic focal leakage on 
      fluorescein angiography. The spontaneous remission rate is 84% within 6 months. 
      In this study, the efficacy of selective retina therapy (SRT) was examined in 
      patients with therapy refractory persistent acute CSC defined by symptoms for at 
      least 6 months and persistent subretinal fluid (SRF) despite eplerenone therapy. 
      MATERIAL AND METHODS: This is a prospective, monocentric observational study in 
      17 eyes (16 patients, mean age 42 years, 2 female). SRT was performed with the 
      approved R:GEN laser (Lutronic, South Korea), a micropulsed 527-nm Nd:YLF laser 
      device, with a train of 30 pulses of 1.7 mus at 100-Hz repetition rate at the 
      point of focal leakage determined by fluorescein angiography (FA) at baseline 
      (BSL). Visits on BSL, week 4 (wk4), and week 12 (wk12) included best corrected 
      visual acuity (BCVA, logMar), central retinal thickness (CRT) on spectral domain 
      optical coherence tomography (SD-OCT), and FA. Statistical analysis was performed 
      by pair-by-pair comparisons of multiple observations in each case with Bonferroni 
      correction for multiple testing. (IBM SPSS Statistics 25(R)). RESULTS: Mean CRT at 
      BSL was 387.69 +/- 110.4 mum. CRT significantly decreased by 106.31 mum in wk4 
      (95%-KI: 21.42-191.2; p = 0.01), by 133.63 mum in wk12 (95%-KI: 50.22-217.03; 
      p = 0.001) and by 133.81 mum (95%-KI: 48.88-218.75; p = 0.001) compared to BSL. 
      Treatment success defined as complete resolution of SRF occurred at wk4 in 7/17 
      eyes (35.3%) and at wk12 in 10/17 eyes (58.8%). Re-SRT was performed in 7/17 eyes 
      (41.2%) after an average of 107.14 +/- 96.59 days. Treatment success after Re-SRT 
      was observed in 4/6 eyes (66.6%, 12 weeks after Re-SRT). Mean BCVA did not change 
      significantly from BSL to any later timepoint after adjusting for multiple 
      testing. Notably, eyes with treatment success showed better BCVA at all 
      timepoints and gained more letters compared to failures. CONCLUSION: Single or 
      repetitive SRT may be an effective and safe treatment in 2 of 3 patients 
      suffering from acute persistent CSC after 6 months of symptoms or more. We 
      observed complete resolution of SRF in around 60% of eyes 12 weeks after first 
      SRT treatment and also 12 weeks after Re-SRT treatment in eyes with persistent or 
      recurrent SRF. Results on the long-term course after SRT are still pending.
FAU - Buttner, Maximilian
AU  - Buttner M
AUID- ORCID: 0000-0002-0537-4322
AD  - University Eye Hospital, Medical School Hannover, Carl-Neuberg-Str.1, 30625, 
      Hannover, Germany. buettner.maximilian@mh-hannover.de.
FAU - Luger, Benjamin
AU  - Luger B
AD  - University Eye Hospital, Medical School Hannover, Carl-Neuberg-Str.1, 30625, 
      Hannover, Germany.
FAU - Abou Moulig, Wasim
AU  - Abou Moulig W
AD  - University Eye Hospital, Medical School Hannover, Carl-Neuberg-Str.1, 30625, 
      Hannover, Germany.
FAU - Junker, Bernd
AU  - Junker B
AD  - University Eye Hospital, Medical School Hannover, Carl-Neuberg-Str.1, 30625, 
      Hannover, Germany.
FAU - Framme, Carsten
AU  - Framme C
AD  - University Eye Hospital, Medical School Hannover, Carl-Neuberg-Str.1, 30625, 
      Hannover, Germany.
FAU - Jacobsen, Christina
AU  - Jacobsen C
AD  - University Eye Hospital, Medical School Hannover, Carl-Neuberg-Str.1, 30625, 
      Hannover, Germany.
FAU - Knoll, Katharina
AU  - Knoll K
AD  - University Eye Hospital, Medical School Hannover, Carl-Neuberg-Str.1, 30625, 
      Hannover, Germany.
FAU - Pielen, Amelie
AU  - Pielen A
AD  - University Eye Hospital, Medical School Hannover, Carl-Neuberg-Str.1, 30625, 
      Hannover, Germany.
CN  - SRT Study Group
LA  - eng
PT  - Journal Article
PT  - Observational Study
DEP - 20201118
PL  - Germany
TA  - Graefes Arch Clin Exp Ophthalmol
JT  - Graefe's archive for clinical and experimental ophthalmology = Albrecht von 
      Graefes Archiv fur klinische und experimentelle Ophthalmologie
JID - 8205248
SB  - IM
MH  - Adult
MH  - *Central Serous Chorioretinopathy/diagnosis/surgery
MH  - Female
MH  - Fluorescein Angiography
MH  - Humans
MH  - Male
MH  - Prospective Studies
MH  - Retina/diagnostic imaging
MH  - Visual Acuity
PMC - PMC8166675
OTO - NOTNLM
OT  - Central serous chorioretinopathy
OT  - Fluorescein angiography
OT  - Micropulse laser
OT  - OCT
OT  - Persistent acute disease
OT  - Selective retina treatment
OT  - Subretinal fluid
COIS- The authors declare that they have no competing interests.
FIR - Abou Moulig, Wasim
IR  - Abou Moulig W
FIR - Awe-Kruger, Marita
IR  - Awe-Kruger M
FIR - Beckmann, Anke
IR  - Beckmann A
FIR - Birngruber, Reginald
IR  - Birngruber R
FIR - Brahms, Jan Hendrik
IR  - Brahms JH
FIR - Brinkmann, Ralf
IR  - Brinkmann R
FIR - Buttner, Maximilian
IR  - Buttner M
FIR - Buley, Pascal
IR  - Buley P
FIR - Danzmann, Lisa
IR  - Danzmann L
FIR - Feltgen, Nicolas
IR  - Feltgen N
FIR - Framme, Carsten
IR  - Framme C
FIR - Hoerauf, Hans
IR  - Hoerauf H
FIR - Jacobsen, Christina Sophie
IR  - Jacobsen CS
FIR - Junker, Bernd
IR  - Junker B
FIR - Kleemann, Katja
IR  - Kleemann K
FIR - Knoll, Katharina
IR  - Knoll K
FIR - Kubler, Vanessa
IR  - Kubler V
FIR - Luger, Benjamin
IR  - Luger B
FIR - Miura, Yoko
IR  - Miura Y
FIR - Peters, Ulrike
IR  - Peters U
FIR - Pielen, Amelie
IR  - Pielen A
FIR - Roider, Johann
IR  - Roider J
FIR - Rosenstein, Christopher
IR  - Rosenstein C
FIR - Seifert, Eric
IR  - Seifert E
FIR - Striebe, Nina-Antonia
IR  - Striebe NA
FIR - Theisen-Kunde, Dirk
IR  - Theisen-Kunde D
FIR - Tode, Jan
IR  - Tode J
FIR - Volkmann, Ingo Roland
IR  - Volkmann IR
EDAT- 2020/11/19 06:00
MHDA- 2021/08/19 06:00
PMCR- 2020/11/18
CRDT- 2020/11/18 06:02
PHST- 2020/03/25 00:00 [received]
PHST- 2020/10/30 00:00 [accepted]
PHST- 2020/10/15 00:00 [revised]
PHST- 2020/11/19 06:00 [pubmed]
PHST- 2021/08/19 06:00 [medline]
PHST- 2020/11/18 06:02 [entrez]
PHST- 2020/11/18 00:00 [pmc-release]
AID - 10.1007/s00417-020-04999-9 [pii]
AID - 4999 [pii]
AID - 10.1007/s00417-020-04999-9 [doi]
PST - ppublish
SO  - Graefes Arch Clin Exp Ophthalmol. 2021 Jun;259(6):1401-1410. doi: 
      10.1007/s00417-020-04999-9. Epub 2020 Nov 18.