Photothermal therapy is safe for chronic CSR

Non-damaging photothermal therapy using a pattern-scanning laser (PASCAL) guided by proprietary software [Endpoint Management (EpM), Topcon Medical Laser Systems] is a safe and effective treatment for chronic central serous retinopathy (CSR), according to a recent study.

The study demonstrated that PASCAL with EpM was safe and improved visual acuity and resolution of subretinal fluid in chronic CSR patients. Furthermore, lack of tissue damage allowed for periodic retreatment without tissue scarring.

The study included 16 patients and demonstrated when using EpM at 30% energy level, the central macular thickness decreased, on average, from 350 μm to 282 μm (p = 0.004). In 75% of patients the subretinal fluid was completely resolved, and in 25% there was some minimal fluid left. Patients gained, on average, 12 ETDRS letters in best-corrected visual acuity at 2 months, which remained steady by 6 months of the follow-up (p

"This clinical study builds on our investigations of the heat shock protein expression after non-damaging laser therapy, and also highlights the role of the thermal stress in resolution of the CSR," said study co-author Dr Daniel Lavinsky, Federal University Rio Grande do Sul. "Since non-damaging treatment is so efficient, conventional photocoagulation may eventually be considered overtreatment."

"While traditional laser coagulation can help in treatment of macular diseases, it leaves the tissue damaged, which makes future retreatment difficult or impossible," added co-author Dr Daniel Palanker, PhD, Stanford University. "Being able to treat the retina without any damage is critical, especially for chronic diseases that require periodic re-treatments. Equally critical is being able to treat patients consistently, preserving their vision while demonstrating long-lasting therapeutic benefits."

To read the abstract of the study from the journal Retina, click here.