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Am Jour Ophthalmol
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Curr Eye Res
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Ophthalmology Review Journal
Ophthalmologica[JOUR] Established 1995
1. Ophthalmologica. 2015 Nov 6. [Epub ahead of print]

Fluctuations in Pigment Epithelial Detachment and Retinal Fluid Using a Bimonthly
Treatment Regimen with Aflibercept for Neovascular Age-Related Macular

Zinkernagel MS(1), Wolf S, Ebneter A.

Author information: 
(1)Department of Ophthalmology, University Hospital Bern, Bern, Switzerland.

PURPOSE: To assess the effect of a bimonthly treatment regimen with intravitreal 
aflibercept on retinal fluid and pigment epithelial detachment (PED) in patients 
with neovascular age-related macular degeneration (AMD).
METHODS: Twenty-six treatment-naive eyes of 26 patients with choroidal
neovascularisation secondary to AMD were included. The patients received three
initial monthly (mean 30 days) intravitreal injections of aflibercept followed by
a bimonthly (mean 62 days) fixed regimen for a total of 1 year. Best-corrected
visual acuity (BCVA) and optical coherence tomography (OCT) measurements were
recorded at monthly intervals. In addition, the presence of intraretinal fluid
(IRF) or subretinal fluid (SRF) or a combination of both as well as serous and
fibrovascular PEDs were assessed.
RESULTS: The mean patient age was 80 years (range 54-93). There were 14 male and 
12 female patients. The mean gain in BCVA at 1 year was 9.3 letters (SEM ±3) with
a mean reduction of the central retinal thickness of 154 µm (SEM ±50). After 3
monthly injections of aflibercept, there was resolution of IRF and SRF in 80% of 
the treated eyes; the amount of fluid increased at months 4, 6 and 8 with troughs
in between. Whereas fibrovascular PEDs remained stable after the loading phase,
serous PEDs displayed a seesaw pattern. Patients without retinal pigment
epithelium (RPE) atrophy at the end of the 1-year period had significantly better
BCVA compared to patients with RPE atrophy (p = 0.03).
CONCLUSION: Despite significant overall BCVA gain, bimonthly intervals seem
insufficient to maintain the morphological improvements after the initial loading
dose with intravitreal aflibercept.

© 2015 S. Karger AG, Basel.

PMID: 26540259   [PubMed - as supplied by publisher]

2. Ophthalmologica. 2015 Nov 6. [Epub ahead of print]

White Matter Changes in Two Leber's Hereditary Optic Neuropathy Pedigrees:
12-Year Follow-Up.

Jančić J(1), Dejanović I, Radovanović S, Ostojić J, Kozić D, Đurić-Jovičić M,
Samardžić J, Ćetković M, Kostić V.

Author information: 
(1)Clinic of Neurology and Psychiatry for Children and Youth, Belgrade, Serbia.

We are presenting two Leber's hereditary optic neuropathy (LHON) pedigrees with
abnormal magnetic resonance imaging (MRI) and proton magnetic resonance
spectroscopy (H-MRS) findings but without neurological manifestation associated
with LHON. The study included 14 LHON patients and 41 asymptomatic family members
from 12 genealogically unrelated families. MRI showed white matter involvement
and H-MRS exhibited metabolic anomalies within 12 LHON families. Main outcome
measures were abnormal MRI and H-MRS findings in two pedigrees. MRI of the
proband of the first pedigree showed a single demyelinating lesion in the right
cerebellar hemisphere, while the proband of the second family displayed multiple 
supratentorial and infratentorial lesions, compatible with the demyelinating
process, and both the absolute choline (Cho) concentration and Cho/creatinine
ratio were increased. MRI and H-MRS profiles of both affected and unaffected
mitochondrial DNA mutation carriers suggest more widespread central nervous
involvement in LHON. Although even after 12 years our patients did not develop
neurological symptoms, MRI could still be used to detect possible changes during 
the disease progression.

© 2015 S. Karger AG, Basel.

PMID: 26540208   [PubMed - as supplied by publisher]

3. Ophthalmologica. 2015 Nov 5. [Epub ahead of print]

Comparison between Outcomes of Vitrectomy in Granulomatous and Nongranulomatous

Takayama K(1), Tanaka A, Ishikawa S, Mochizuki M, Takeuchi M.

Author information: 
(1)Department of Ophthalmology at National Defense Medical College, Saitama,

PURPOSE: The aim of this study was to compare the outcomes of vitrectomy in
granulomatous uveitis and nongranulomatous uveitis insufficiently managed by
immunosuppressive therapy.
METHODS: Thirty-eight eyes with granulomatous uveitis and 17 eyes with
nongranulomatous uveitis that underwent vitrectomy for ocular complications
between July 2006 and August 2012 were reviewed retrospectively. Visual acuity
and ocular inflammation scores before and 6 months after surgery were compared.
Patients treated with vitrectomy alone and those in whom vitrectomy was combined 
with phacoemulsification were analyzed separately.
RESULTS: The mean visual acuity improved significantly both in granulomatous and 
nongranulomatous uveitis. In granulomatous uveitis, the mean inflammation scores 
decreased significantly both in the anterior segment and in the posterior
segment. In nongranulomatous uveitis, the mean inflammation score in the
posterior segment decreased significantly, although it did not change in the
anterior segment.
CONCLUSION: Vitrectomy was effective for treating ocular complications both in
granulomatous uveitis and nongranulomatous uveitis, with favorable outcomes of
improved visual acuity and decreased uveitis activity.

© 2015 S. Karger AG, Basel.

PMID: 26536452   [PubMed - as supplied by publisher]

4. Ophthalmologica. 2015 Oct 22. [Epub ahead of print]

Retinal Pigment Epithelium Tears: Risk Factors, Mechanism and Therapeutic

Clemens CR(1), Eter N.

Author information: 
(1)Department of Ophthalmology, University of Mx00FC;nster Medical Centre,
Mx00FC;nster, Germany.

Tears of the retinal pigment epithelium (RPE) are most commonly associated with
vascularised RPE detachment due to age-related macular degeneration (AMD), and
they usually involve a deleterious loss in visual acuity. Recent studies suggest 
an increase in RPE tear incidences since the introduction of anti-vascular
endothelial growth factor (anti-VEGF) therapies as well as a temporal association
between the tear event and the intravitreal injection. As the number of AMD
patients and the number of administered anti-VEGF injections increase, both the
challenge of RPE tear prevention and the treatment after RPE tear formation have 
become more important. At the same time, the evolution of retinal imaging has
significantly contributed to a better understanding of RPE tear development in
recent years. This review summarises the current knowledge on RPE tear
development, predictive factors, and treatment strategies before and after RPE
tear formation.

© 2015 S. Karger AG, Basel.

PMID: 26489018   [PubMed - as supplied by publisher]

5. Ophthalmologica. 2015 Oct 21. [Epub ahead of print]

Evaluation of Choroidal Vascular Changes in Patients with Multiple Sclerosis
Using Enhanced Depth Imaging Optical Coherence Tomography.

Esen E(1), Sizmaz S, Demir T, Demirkiran M, Unal I, Demircan N.

Author information: 
(1)Department of Ophthalmology, Cukurova University School of Medicine, Adana,

OBJECTIVE: To evaluate the choroidal thickness in patients with multiple
sclerosis (MS) using enhanced depth imaging optical coherence tomography
METHODS: In this observational comparative study, 68 eyes of 34 MS patients and
60 eyes of 30 healthy subjects were evaluated. All participants underwent
complete ophthalmologic examination and OCT scanning. Choroidal thickness
measurements were performed at seven points.
RESULTS: The mean subfoveal choroidal thickness was reduced significantly in MS
patients (310.71 ± 61.85 μm) versus healthy controls (364.85 ± 41.81 μm) (p <
0.001). The difference was also significant at all six measurement points (p <
0.001 for all). Choroidal thickness measurements revealed no significant
difference between MS eyes with a prior optic neuritis (ON) history (MS ON) and
those without ON history (MS non-ON). Subfoveal choroidal thickness did not
correlate with retinal nerve fiber layer and Expanded Disability Status Scale
score, but reduced choroidal thickness was associated with longer disease
duration (r = -0.28, p = 0.019) in MS patients.
CONCLUSION: In MS patients, choroidal structural changes occur both in MS ON and 
MS non-ON eyes. The decreased choroidal thickness might provide evidence to
support a potential role of vascular dysregulation in the pathophysiology of MS.

© 2015 S. Karger AG, Basel.

PMID: 26485541   [PubMed - as supplied by publisher]

6. Ophthalmologica. 2015 Oct 21. [Epub ahead of print]

Association between Ocular Axial Length-Related Genes and High Myopia in a Han
Chinese Population.

Li YT(1), Xie MK, Wu J.

Author information: 
(1)Department of Forensic Genetics, West China School of Basic Science and
Forensic Medicine, Sichuan University, Chengdu, PR China.

AIMS: A previous genome-wide association study of high myopia identified five
genome-wide loci for ocular axial length (C3orf26, ZC3H11B, RSPO1, GJD2, and
ZNRF3). The aim of our study was to investigate the association between high
myopia and genetic variants in the five loci in Han Chinese subjects.
METHODS: Five single nucleotide polymorphisms were genotyped in 296 unrelated
high-myopia subjects and 300 matched emmetropic controls by the SNaPshot method. 
The distribution of genotypes in the cases and controls was compared in
codominant, dominant, and recessive genetic models by using SNPStats online
RESULTS: Significant associations between rs994767 near ZC3H11B (p = 0.001),
rs4074961 in RSPO1 (p < 0.001), and rs11073058 in GJD2 (p = 0.029) and high
myopia were observed. Odds ratios (95% confidence intervals) were 1.532
(1.200-1.955), 1.603 (1.267-2.029), and 1.290 (1.027-1.621) for the rs994767 T
allele, rs4074961 T allele, and rs11073058 T allele, respectively. But rs9811920 
in C3orf26 and rs12321 in ZNRF3 were not associated with high myopia.
CONCLUSION: Our findings suggested that genetic variants in ZC3H11B, RSPO1, and
GJD2 are associated with susceptibility to the development of high myopia in a
Han Chinese population. Functional roles of ZC3H11B, RSPO1, and GJD2 in the
pathology of high myopia need to be further investigated.

© 2015 S. Karger AG, Basel.

PMID: 26485405   [PubMed - as supplied by publisher]

7. Ophthalmologica. 2015 Oct;234(4):189-94. doi: 10.1159/000439600. Epub 2015 Sep

Subthreshold Micropulse Laser (577 nm) Treatment in Chronic Central Serous

Scholz P(1), Ersoy L, Boon CJ, Fauser S.

Author information: 
(1)Department of Ophthalmology, University Hospital of Cologne, Cologne, Germany.

PURPOSE: To assess treatment with a 577-nm subthreshold micropulse laser (SML) in
patients with chronic central serous chorioretinopathy (cCSC).
METHODS: This retrospective study included 38 patients treated with a 577-nm SML 
(Supra Scan; Quantel Medical) for cCSC. We included a subgroup of 18 patients
with persistent subretinal fluid (SRF) after photodynamic therapy (PDT).
Assessment included visual acuity (VA), central retinal thickness (CRT) and
resolution of SRF.
RESULTS: At the last follow-up (mean 5 months), 74% of patients responded to
therapy. The CRT decreased after treatment (mean CRT -115 µm, p < 0.001) and VA
improved (mean logMAR -0.06, p = 0.039). No laser burns were detected with any
imaging modality. In the subgroup of patients resistant to PDT, 61% of patients
responded to therapy with a decrease in CRT (mean CRT -75 µm, p = 0.019).
CONCLUSIONS: The 577-nm SML is an effective treatment for cCSC even in patients
without sufficient improvement after PDT.

© 2015 S. Karger AG, Basel.

PMID: 26406874   [PubMed - in process]

8. Ophthalmologica. 2015 Oct;234(4):233-42. doi: 10.1159/000439359. Epub 2015 Sep

Characteristics of Neovascular Age-Related Macular Degeneration in Brazilian

Pereira FB(1), Veloso CE, Kokame GT, Nehemy MB.

Author information: 
(1)Department of Ophthalmology, Federal University of Minas Gerais, Belo
Horizonte, Brazil.

PURPOSE: To report features of neovascular age-related macular degeneration (AMD)
in Brazilian patients.
PROCEDURES: Data were prospectively collected from patients diagnosed with
neovascular AMD. Eyes were classified as having typical neovascular AMD,
polypoidal choroidal vasculopathy (PCV), or retinal angiomatous proliferation
RESULTS: In total, 265 eyes of 207 patients of predominantly Caucasian ancestry
were included; 166 (62.6%) eyes had typical neovascular AMD, 65 (24.5%) eyes had 
PCV, and 34 (12.8%) eyes had RAP. RAP demonstrated a higher percentage of
bilateral cases (p = 0.015). The mean foveal subfield thickness was significantly
lower in eyes with PCV (p < 0.001). Cases with typical neovascular AMD had a
higher percentage of predominantly classic and minimally classic lesions on
fluorescein angiography (FA; p = 0.005).
CONCLUSIONS: In Brazilian patients, PCV and RAP represented 24.5 and 12.8% of
neovascular AMD cases. Neovascular AMD subtypes differ in relation to clinical
features, mean foveal subfield thickness and FA presentation.

© 2015 S. Karger AG, Basel.

PMID: 26394133   [PubMed - in process]

9. Ophthalmologica. 2015 Oct;234(4):218-26. doi: 10.1159/000439358. Epub 2015 Sep

Long-Term Follow-Up of Fundus Autofluorescence Imaging Using Wide-Field Scanning 
Laser Ophthalmoscopy.

Duisdieker V(1), Fleckenstein M, Zilkens KM, Steinberg JS, Holz FG,
Schmitz-Valckenberg S.

Author information: 
(1)Department of Ophthalmology, University of Bonn, Bonn, Germany.

AIM: To evaluate the variation of peripheral alterations in different retinal
diseases over a period of >3 years by using wide-field fundus autofluorescence
(FAF) scanning laser ophthalmoscopy (SLO).
METHODS: A total of 26 eyes from 13 patients (median age 66 years, range 19-80)
with age-related macular degeneration and other retinal degenerations were
examined. In 2009, the Optos P200CAF prototype and from 2012 onwards, the Optos
200Tx (Optos plc, Scotland) were used for wide-field FAF SLO (excitation 532 nm).
RESULTS: The area involvement in outer retinal pathological alterations, such as 
atrophy and mottling of the retinal pigment epithelium far beyond the vascular
arcades, was readily and better visualized within one image frame using
wide-field FAF as compared to pseudocolor SLO of the same device. Over time,
progression of existing and the development of de novo peripheral lesions were
recorded with a concomitant enlargement of central lesions. In two cases
(unilateral paravenous pigmented choroidal atrophy and suspected phenocopy of
retinal dystrophy), no longitudinal changes of the topographic distribution of
peripheral FAF intensities were noted.
CONCLUSIONS: Wide-field FAF SLO allows the mapping of dynamic changes at the
outer retina far beyond the vascular arcades. While its ability to detect and
monitor these changes appears to be better than that of pseudocolor imaging,
wide-field FAF SLO may not only be helpful to assess more widespread retinal
dysfunction, but may also be useful for longitudinal assessments in natural
history studies and interventional clinical trials.

© 2015 S. Karger AG, Basel.

PMID: 26394020   [PubMed - in process]

10. Ophthalmologica. 2015 Oct;234(4):211-7. doi: 10.1159/000439182. Epub 2015 Sep 23.

Refractive Error in Patients with Retinopathy of Prematurity after Laser
Photocoagulation or Bevacizumab Monotherapy.

Kuo HK(1), Sun IT, Chung MY, Chen YH.

Author information: 
(1)Department of Ophthalmology, Kaohsiung Chang-Gung Memorial Hospital,
Kaohsiung, Taiwan, ROC.

PURPOSE: To evaluate the refractive development of premature infants with
retinopathy of prematurity (ROP) after treatment with laser photocoagulation or
intravitreal injection of bevacizumab (IVB).
METHODS: The medical records of patients with ROP treated between 2003 and 2012
who underwent yearly follow-ups were retrospectively reviewed. Patients with
residual ROP abnormalities were excluded. The cycloplegic refraction at 3 years
of age, assessed using an autorefractometer, was recorded.
RESULTS: In total, 54 eyes from 54 patients were enrolled. Patients were divided 
into 4 groups: group 1, including 14 eyes of 14 patients treated with laser
therapy; group 2, 15 eyes of 15 patients treated with IVB; group 3, 13 eyes of 13
patients with non-type 1 ROP under conservative follow-up, and group 4, 12 eyes
of 12 premature patients without ROP. The mean spherical equivalent at 3 years of
age was -1.71 ± 1.27 dpt in group 1, -1.53 ± 2.20 dpt in group 2, 0.63 ± 1.37 dpt
in group 3, and 0.41 ± 1.95 dpt in group 4. The mean refractive error differed
significantly among the 4 groups (p < 0.001). Patients in groups 1 and 2 were
more prone to myopia compared with those in groups 3 and 4. Furthermore, patients
with type 1 ROP treated by laser photocoagulation (group 1) and those treated by 
IVB (group 2) had similar refraction (p = 1).
CONCLUSIONS: The results of this study suggest that treatment-demanding ROP eyes 
are susceptible to more severe myopia with age compared with eyes without ROP or 
those with spontaneously regressed ROP. In addition, the myopic status between
laser and IVB treatment did not differ statistically.

© 2015 S. Karger AG, Basel.

PMID: 26393895   [PubMed - in process]

11. Ophthalmologica. 2015;234(3):139-50. doi: 10.1159/000437360. Epub 2015 Sep 23.

Indocyanine Green Angiography-Guided Focal Laser Photocoagulation for Diabetic
Macular Edema.

Ogura S(1), Yasukawa T, Kato A, Kuwayama S, Hamada S, Hirano Y, Uemura A, Yoshida
M, Ogura Y.

Author information: 
(1)Department of Ophthalmology and Visual Science, Nagoya City University
Graduate School of Medical Sciences, Nagoya, Japan.

PURPOSE: To evaluate the usefulness of indocyanine green angiography (ICGA) to
detect leaking spots and the effectiveness of ICGA-guided focal laser
photocoagulation in eyes with diabetic macular edema (DME).
METHODS: Ten eyes (8 patients) with diffuse DME diagnosed using fluorescein
angiography (FA) and refractory to a sub-Tenon injection of triamcinolone
acetonide (STTA), grid laser photocoagulation, or both were enrolled. FA and ICGA
were performed using the Heidelberg Retina Angiograph 2. Hyperfluorescent spots
on early-phase FA and on early- and late-phase ICGA were superimposed onto the
macular thickness map measured by optical coherence tomography (OCT) and counted 
to calculate the spot density in the area with or without macular edema (ME).
ICGA-guided focal laser photocoagulation was carried out. In 7 eyes, STTA was
simultaneously performed. The central macular thickness (CRT) and macular volume 
(MV) were measured by OCT.
RESULTS: On early-phase FA, 4.8 ± 2.3 and 2.3 ± 1.5 hyperfluorescent spots/disk
area were observed inside and outside the ME, respectively. In contrast, the spot
density was significantly decreased to 1.8 ± 0.9 inside the ME and was only 0.3 ±
0.4 outside the ME on late-phase ICGA (p < 0.01). The mean follow-up period after
ICGA-guided photocoagulation was 19.0 months. The mean best-corrected visual
acuity improved significantly from 0.77 ± 0.34 logarithm of the minimum angle of 
resolution at baseline to 0.52 ± 0.37 at the last visit (p < 0.01). Both CRT and 
MV significantly decreased (p < 0.01). Recurrence of DME was observed in 4 eyes: 
3 eyes were treatable only with STTA and 1 required additional ICGA-guided laser 
CONCLUSIONS: ICGA may be useful to detect leaking spots responsible for DME,
enabling less invasive focal laser photocoagulation even in some of the eyes with
diffuse DME.

© 2015 S. Karger AG, Basel.

PMID: 26393771   [PubMed - in process]

12. Ophthalmologica. 2015 Oct;234(4):227-32. doi: 10.1159/000439357. Epub 2015 Sep

Intra-Arterial Chemotherapy for Retinoblastoma: A Single-Center Experience.

Akyüz C(1), Kıratlı H, Şen H, Aydın B, Tarlan B, Varan A.

Author information: 
(1)Department of Pediatric Oncology, Cancer Institute, Hacettepe University,
Ankara, Turkey.

BACKGROUND: Studies conducted in recent years have reported promising results
regarding the treatment of retinoblastoma with the intra-arterial use of
melphalan. In the present study, we intended to report the results of
intra-arterial chemotherapy with melphalan (IACT) in the treatment of newly
diagnosed or relapsed-refractory retinoblastoma patients at the Department of
Pediatric Oncology of Hacettepe University, Ankara, Turkey.
MATERIALS AND METHODS: This was a retrospective study of patients with
intraocular retinoblastoma who were treated with IACT from December 2011 to May
2014. A total of 56 eyes of 46 consecutive patients (30 males and 16 females)
were included in the study. Forty-four eyes received systemic chemotherapy upon
diagnosis (systemic chemotherapy group, SCG), and 12 eyes were those of newly
diagnosed patients (primary intra-arterial melphalan group, PIAG). The choice of 
the IACT dose was based on age. Tumor control and globe salvage with IACT were
analyzed. Complete blood counts were examined 7 days after the IACT for systemic 
toxicity. Ocular toxicities such as proptosis, eyelid edema, ocular motility, and
retinal and optic atrophy were assessed by an ocular oncologist with regular
ophthalmologic examinations.
RESULTS: Enucleation was avoided overall in 66% (37/56) of the eyes, including
75% (9/12) in the PIAG and 64% (28/44) in the SCG patients. The 1-year
enucleation-free survival rate was 56.7% at a median follow-up time of 11.9
months (range 0.27-27.6). IACT was administered in a total of 124 cycles (ranging
from 1 to 7 cycles, mean 2.3). The responses were as follows: regression of the
retinal tumor in 27 eyes and improvements in vitreous seeding in 5 of 15 eyes.
The further treatment requirements after IACT were as follows: enucleation in 19 
eyes (10 with vitreous seeding), radiotherapy in 3 eyes, systemic chemotherapy in
1 eye, and local therapy in 1 eye. No severe systemic side effects occurred.
Transient swelling of the eyelids (22 patients), conjunctival chemosis (12
patients), upper eyelid ptosis (5 patients), redness over the frontal area (3
patients), limitation of ocular motility (3 patients) and mild proptosis (1
patient) were detected. Retinal pigment epithelial alterations (30 patients) and 
optic atrophy (3 patients) were seen in the late follow-up.
CONCLUSIONS: Globe salvage and avoidance of radiotherapy may be achieved by IACT 
with limited toxicity. This treatment is efficient, repeatable and safe.

© 2015 S. Karger AG, Basel.

PMID: 26368674   [PubMed - in process]

13. Ophthalmologica. 2015 Oct;234(4):177-88. doi: 10.1159/000439188. Epub 2015 Sep

Selective Retina Therapy in Acute and Chronic-Recurrent Central Serous

Framme C(1), Walter A, Berger L, Prahs P, Alt C, Theisen-Kunde D, Kowal J,
Brinkmann R.

Author information: 
(1)University Eye Hospital, Medical School Hannover, Hannover, Germany.

PURPOSE: Selective retina therapy (SRT), the confined laser heating and
destruction of retinal pigment epithelial cells, has been shown to treat acute
types of central serous chorioretinopathy (CSC) successfully without damaging the
photoreceptors and thus avoiding laser-induced scotoma. However, a benefit of
laser treatment for chronic forms of CSC is questionable. In this study, the
efficacy of SRT by means of the previously used 1.7-µs and shorter 300-ns pulse
duration was evaluated for both types of CSC, also considering re-treatment for
MATERIAL AND METHODS: In a two-center trial, 26 patients were treated with SRT
for acute (n = 10) and chronic-recurrent CSC (n = 16). All patients presented
with subretinal fluid (SRF) in OCT and leakage in fluorescein angiography (FA).
SRT was performed using a prototype SRT laser system (frequency-doubled
Q-switched Nd:YLF-laser, wavelength 527 nm) with adjustable pulse duration. The
following irradiation settings were used: a train of 30 laser pulses with a
repetition rate of 100 Hz and pulse durations of 300 ns and 1.7 µs, pulse energy 
120-200 µJ, retinal spot size 200 µm. Because SRT lesions are invisible, FA was
always performed 1 h after treatment to demonstrate laser outcome (5-8 single
spots in the area of leakage). In cases where energy was too low, as indicated by
missing FA leakage, energy was adjusted and the patient re-treated immediately.
Observation intervals were after 4 weeks and 3 months. In case of nonimprovement 
of the disease after 3 months, re-treatment was considered.
RESULTS: Of 10 patients with active CSC that presents focal leakage in FA, 5 had 
completely resolved fluid after 4 weeks and all 10 after 3 months. Mean visual
acuity increased from 76.6 ETDRS letters to 85.0 ETDRS letters 3 months after
SRT. Chronic-recurrent CSC was characterized by less severe SRF at baseline in
OCT and weaker leakage in FA than in acute types. Visual acuity changed from
baseline 71.6 to 72.8 ETDRS letters after 3 months. At this time, SRF was absent 
in 3 out of 16 patients (19%), FA leakage had come to a complete stop in 6 out of
16 patients (38%). In 6 of the remaining chronic CSC patients, repeated SRT with 
higher pulse energy was considered because of persistent leakage activity. After 
the re-treatment, SRF resolved completely in 5 patients (83.3%) after only 25
CONCLUSION: SRT showed promising results in treating acute CSC, but was less
effective in chronic cases. Interestingly, re-treatment resulted in enhanced
fluid resolution and dry conditions after a considerably shorter time in most
patients. Therefore, SRT including re-treatment if necessary might be a valuable 
CSC treatment alternative even in chronic-recurrent cases.

© 2015 S. Karger AG, Basel.

PMID: 26368551   [PubMed - in process]