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Gawecki M, Pytrus W, Swiech A, Mackiewicz J, Lytvynchuk L. Laser Treatment of Central Serous Chorioretinopathy - An Update. Klin Monbl Augenheilkd 2024. [PMID: 39047764 DOI: 10.1055/a-2338-3235] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/27/2024]
Abstract
Laser treatment has been a mainstay for management of central serous chorioretinopathy for a few decades. Different types of lasers have been used and non-damaging retinal laser is the most recent option. The aim of this review is to provide an update on this form of treatment, based on the research published during last 5 years, in comparison with earlier studies published. A MEDLINE database search was performed with a combination of the following terms: central serous chorioretinopathy and laser photocoagulation or subthreshold laser or subthreshold micropulse laser or nanosecond laser or microsecond laser or end-point management or photodynamic therapy. Results were analyzed separately for each modality of laser treatment. Reports published in recent years confirm findings of previous research and do not distinguish treatments of this clinical entity. Among all analyzed laser options, photodynamic therapy provides the fastest and most prominent morphological improvements, including subretinal fluid resorption and reduction of choroidal thickness. This modality is also associated with fewer recurrences than with other treatments. Subthreshold micropulse laser allows the physician to maintain and, in selected cases, improve the patient's vision. Conventional photocoagulation is still effective, especially with the introduction of navigated laser systems. Despite the availability of variable laser treatment options, long-term functional improvements in chronic cases are minor for each modality. Long-lasting central serous chorioretinopathy cases with significantly altered retinal morphology do not usually present with functional improvement, despite satisfactory morphological outcomes. Early initiation of treatment has the potential to prevent visual loss and to improve the patient's quality of life.
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Affiliation(s)
- Maciej Gawecki
- Ophthalmology, Dobry Wzrok Ophthalmological Clinic, Gdansk, Poland
| | | | - Anna Swiech
- Chair of Ophthalmology, Department of Vitreoretinal Surgery, Medical University of Lublin, Poland
| | - Jerzy Mackiewicz
- Chair of Ophthalmology, Department of Vitreoretinal Surgery, Medical University of Lublin, Poland
| | - Lyubomyr Lytvynchuk
- Department of Ophthalmology, Eye Clinic, Justus Liebig University, University Hospital Giessen and Marburg, Campus Giessen, Giessen, Germany
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Kiraly P. Effective Focal Laser Photocoagulation for Persistent Central Serous Chorioretinopathy: A Forgotten Technique. Klin Monbl Augenheilkd 2024; 241:768-771. [PMID: 38086411 PMCID: PMC11213622 DOI: 10.1055/a-2227-4037] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2023] [Accepted: 12/10/2023] [Indexed: 01/19/2024]
Affiliation(s)
- Peter Kiraly
- Oxford Eye Hospital, Oxford University Hospitals NHS Foundation Trust, Oxford, United Kingdom of Great Britain and Northern Ireland
- Nuffield Laboratory of Ophthalmology, University of Oxford Nuffield Laboratory of Ophthalmology, Oxford, United Kingdom of Great Britain and Northern Ireland
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Li A, Wei X, Xie Y, Ren Y, Zhu X, Liu M, Liu S. Light exposure and its applications in human health. JOURNAL OF BIOPHOTONICS 2024; 17:e202400023. [PMID: 38576140 DOI: 10.1002/jbio.202400023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/24/2024] [Revised: 03/13/2024] [Accepted: 03/25/2024] [Indexed: 04/06/2024]
Abstract
Light exposure has been proven to have a significant impact on human health. As a result, researchers are increasingly exploring its potential benefits and drawbacks. With advancements in understanding light and the manufacturing of light sources, modern health lighting has become widely utilized in daily life and plays a critical role in the prevention and treatment of various illnesses. The use of light in healthcare is a global trend, with many countries actively promoting the development and application of relevant scientific research and medical technology. This field has gained worldwide attention and support from scientists and doctors alike. In this review, we examine the application of lighting in human health and recent breakthroughs in light exposure related to pathology, therapeutic strategies, molecular changes, and more. Finally, we also discuss potential future developments and areas of application.
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Affiliation(s)
- Angze Li
- School of Information Science and Technology, Fudan University, Shanghai, China
- Zhongshan Fudan Joint Innovation Center, Zhongshan, Guangdong Province, China
| | - Xiaoling Wei
- Department of Endodontics, Shanghai Stomatological Hospital, Fudan University, Shanghai, China
- Shanghai Key Laboratory of Craniomaxillofacial Development and Diseases, Shanghai Stomatological Hospital, Fudan University, Shanghai, China
| | - Yajia Xie
- Department of Endodontics, Shanghai Stomatological Hospital, Fudan University, Shanghai, China
- Shanghai Key Laboratory of Craniomaxillofacial Development and Diseases, Shanghai Stomatological Hospital, Fudan University, Shanghai, China
| | - Yi Ren
- School of Information Science and Technology, Fudan University, Shanghai, China
- Zhongshan Fudan Joint Innovation Center, Zhongshan, Guangdong Province, China
| | - Xi Zhu
- Zhongshan Fudan Joint Innovation Center, Zhongshan, Guangdong Province, China
| | - Muqing Liu
- School of Information Science and Technology, Fudan University, Shanghai, China
- Zhongshan Fudan Joint Innovation Center, Zhongshan, Guangdong Province, China
| | - Shangfeng Liu
- Shanghai Key Laboratory of Craniomaxillofacial Development and Diseases, Shanghai Stomatological Hospital, Fudan University, Shanghai, China
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Gawęcki M, Kiciński K, Grzybowski A. Crossover to PDT after the unsuccessful micropulse laser treatment of central serous chorioretinopathy. ADVANCES IN OPHTHALMOLOGY PRACTICE AND RESEARCH 2024; 4:32-38. [PMID: 38406665 PMCID: PMC10891284 DOI: 10.1016/j.aopr.2024.01.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/09/2024] [Revised: 01/15/2024] [Accepted: 01/18/2024] [Indexed: 02/27/2024]
Abstract
Purpose Subthreshold micropulse laser (SML) and photodynamic therapy (PDT) are among the most effective therapeutic modalities applied to central serous chorioretinopathy (CSCR). This study aimed to evaluate the efficacy and durability of PDT in CSCR cases unresponsive to at least two SML treatments. Methods The study included 26 consecutive eyes of 24 patients (21 males and three females) with chronic CSCR. In all cases, a lack of reduction in subretinal fluid (SRF) levels was noted after at least two consecutive SML sessions. The parameters of best corrected visual acuity (BCVA) and spectral domain optical coherence tomography (SD-OCT) were evaluated at baseline and 1, 3 and 12 months post-PDT. Results The mean duration of symptoms in the group was 53.81 ± 39.48 months, the mean age of the patients was 49.26 ± 12.91 years, and the mean subfoveal choroidal thickness (SFCT) was 572.11 ± 116.21 mm. Complete resorption of SRF was observed in 21 out of 26 eyes (80.77%) at 1 month and sustained in 18 cases (69.23%) at 12 months. At 12 months, in the sustained group, BCVA improved significantly from 0.39 ± 0.18 to 0.19 ± 0.2 logMAR (P = 0.01), central subfoveal thickness (CST) reduced from 316.44 ± 75.83 mm to 197.67 ± 22.99 mm (P < 0.0001), and SFCT reduced from 579.28 mm to 446.78 mm (P < 0.0001). Conclusions PDT provides the opportunity for the successful treatment of CSCR unresponsive to SML treatment. Improvements are possible even in cases with a long duration of symptoms and significant alterations in retinal morphology. Thus, PDT should be considered for patients with prominently increased choroidal thickness.
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Affiliation(s)
- Maciej Gawęcki
- Dobry Wzrok Ophthalmological Clinic, 80-822, Gdansk, Poland
- Department of Ophthalmology, Pomeranian Hospitals in Wejherowo, 84-200, Wejherowo, Poland
| | - Krzysztof Kiciński
- Department of Ophthalmology, Pomeranian Hospitals in Wejherowo, 84-200, Wejherowo, Poland
| | - Andrzej Grzybowski
- Institute for Research in Ophthalmology, Foundation for Ophthalmology Development, Poznan, Poland
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Bhattacharyya S, Saurabh K, Das S, Gorhe S, D'souza Z, Roy R. Presentation and outcome of central serous chorioretinopathy with and without pachychoroid. Eye (Lond) 2024; 38:127-131. [PMID: 37369762 PMCID: PMC10764852 DOI: 10.1038/s41433-023-02645-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2022] [Revised: 05/18/2023] [Accepted: 06/15/2023] [Indexed: 06/29/2023] Open
Abstract
BACKGROUND The present study compared clinical features and outcomes of central serous chorioretinopathy (CSC) with and without pachychoroid. METHODS It was a retrospective, longitudinal, record-based study which included eyes with CSC. Patients underwent spectral domain optical coherence tomography and differentiated between pachychoroid and non-pachychoroid groups. Eyes were divided into pachychoroid and non-pachychoroid groups based on the subfoveal choroidal thickness of 300 microns and the presence of pachyvessels. RESULTS A total of 250 eyes of 250 patients were divided into pachychoroid and non-pachychoroid with 125 eyes in each group. Mean ages of patients in pachychoroid and non-pachychoroid groups were 45.7 ± 9.4 years and 47.4 ± 10.2 years, respectively. Mean initial best-corrected visual acuity (BCVA) was 0.40 ± 0.42 in pachychoroid and 0.39 ± 0.38 in non-pachychoroid group (p = 0.9). Mean final BCVA was 0.37 ± 0.9 in pachychoroid and 0.21 ± 0.33 in non-pachychoroid group (p = 0.04). 36 (28.8%) eyes in pachychoroid and 60 (48%) eyes in non-pachychoroid group had spontaneous resolution of CSC (p = 0.007). A total of 39 (31.2%) eyes in pachychoroid and 13 (10.4%) in non-pachychoroid group had recurrent CSC at the end of follow-up. CONCLUSION CSC eyes with pachychoroid had more recurrent episodes and less spontaneous resolution compared to CSC eyes in non-pachychoroid group. Final visual acuity was worse in eyes with CSC and pachychoroid. These findings need to be validated in a larger sample size with a prospective study design.
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Affiliation(s)
- Sampurna Bhattacharyya
- Aditya Birla Sankara Nethralaya, 147, Mukundapur, E. M. Bypass, Kolkata, 700 099, West Bengal, India
| | - Kumar Saurabh
- Netralayam, 330 Mukundapur Main Road, E. M. Bypass, Kolkata, 700 099, India
| | - Sudipta Das
- Netralayam, 330 Mukundapur Main Road, E. M. Bypass, Kolkata, 700 099, India
| | - Sukanya Gorhe
- Aditya Birla Sankara Nethralaya, 147, Mukundapur, E. M. Bypass, Kolkata, 700 099, West Bengal, India
| | - Zubin D'souza
- Aditya Birla Sankara Nethralaya, 147, Mukundapur, E. M. Bypass, Kolkata, 700 099, West Bengal, India
| | - Rupak Roy
- Aditya Birla Sankara Nethralaya, 147, Mukundapur, E. M. Bypass, Kolkata, 700 099, West Bengal, India.
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Enríquez-Fuentes JE, Alarcón-García AD, Oribio-Quinto C, Fernández-Vigo JI. Hyperplasia of the retinal pigment epithelium secondary to subthreshold laser treatment in chronic central serous chorioretinopathy. Photodiagnosis Photodyn Ther 2023; 44:103896. [PMID: 37984527 DOI: 10.1016/j.pdpdt.2023.103896] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2023] [Revised: 11/11/2023] [Accepted: 11/14/2023] [Indexed: 11/22/2023]
Abstract
PURPOSE To assess the development of hyperplasia of the retinal pigment epithelium (HRPE) secondary to subthreshold laser treatment (STL) in chronic central serous chorioretinopathy (CSCR). METHODS Prospective study including 149 eyes of 146 patients with CSCR with persistent subretinal fluid (SRF) that have undergone STL using the Navilas® device. Visual acuity (VA) optical coherence tomography (OCT) and fundus autofluorescence (FAF) were performed before and after the treatment. The HRPE was identified on OCT as a hyperreflective and dense material at the expense of the RPE that did not exist prior to the treatment. The demographics of the patients as well as the parameters of the STL treatments employed were registered. RESULTS Seven HRPE cases after STL were identified, observing an incidence of 4.7% (7 out of 149 eyes). The mean age was 52.1 ± 3.6 years, being 6/7 males. The mean number of STL sessions was 1.3 ± 0.5. The mean total fluence applied was 52.2 ± 12.4 J/cm2 (range 35.37 to 76.39 J/cm2), using a duty cycle of 10% in all cases. The HRPE was subfoveal in 6 of the 7 cases. The SRF was resolved in 6 of the 7 patients. The mean VA loss was -14.1 ± 14.3 ETDRS letters. CONCLUSION The development of HRPE secondary to STL in CSCR is an uncommon but severe adverse effect, probably related to the excessive energy employed. Further studies are warranted to minimize the incidence and to know the predictors of this complication after STL treatment to optimize the parameters that should be used.
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Affiliation(s)
- Jacobo Emilio Enríquez-Fuentes
- Department of Ophthalmology, Hospital Clínico San Carlos, Instituto de Investigación Sanitaria (IdISSC), Madrid 28040, Spain
| | - Antonio Domingo Alarcón-García
- Department of Ophthalmology, Hospital Clínico San Carlos, Instituto de Investigación Sanitaria (IdISSC), Madrid 28040, Spain
| | - Carlos Oribio-Quinto
- Department of Ophthalmology, Hospital Clínico San Carlos, Instituto de Investigación Sanitaria (IdISSC), Madrid 28040, Spain
| | - José Ignacio Fernández-Vigo
- Department of Ophthalmology, Hospital Clínico San Carlos, Instituto de Investigación Sanitaria (IdISSC), Madrid 28040, Spain; Centro Internacional de Oftalmología Avanzada, Madrid, Spain.
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Shaimova VA, Trubilin VN, Shaimov TB, Islamova GR, Shaimov RB, Kuchkildina SK, Askaeva AA, Fomin AV. [Subthreshold micropulse laser treatment of the foveal region in chronic central serous chorioretinopathy (case study)]. Vestn Oftalmol 2023; 139:65-70. [PMID: 37638574 DOI: 10.17116/oftalma202313904165] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/29/2023]
Abstract
The article presents a clinical case of subthreshold micropulse laser (SML) treatment of chronic central serous chorioretinopathy (CSC) in the left eye of a 44-year-old female patient K. with dye allergy. The patient first noticed a gray spot, distortion of objects in February, 2018. During 2018-2020 she suffered 5 relapses, repeated unsuccessful conservative treatment, and completed a course of antiangiogenic therapy in the form of three monthly intravitreal injections of ranibizumab. After experiencing stress on 11.08.20 she noted acute deterioration. Laser treatment was carried out on 20.09.20 with the Navilas 577s navigation system (wavelength 577 nm). After the power titration and calculation, the contact-free subthreshold micropulse laser treatment was carried out without anesthesia in three zones: 200 mW for fovea, 240 mW for parafovea and 340 mW for periphovea. Other settings: pulse duration - 200 ms, spot diameter - 100 µm, duty cycle - 5%. Total number of laser pulses - 1000. The retina reattached completely despite the patient having previously recovered from the coronavirus infection and the use of corticosteroids.
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Affiliation(s)
- V A Shaimova
- Academy of Postgraduate Education of the Federal Scientific and Clinical Center for Specialized Medical Assistance and Medical Technologies of the Federal Medical Biological Agency, Moscow, Russia
- OOO Centr Zreniya, Chelyabinsk, Russia
| | - V N Trubilin
- A.I. Burnasyan Federal Medical Biophysical Center of the Federal Medical Biological Agency, Moscow, Russia
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Park JB, Kim K, Kang MS, Kim ES, Yu SY. Subretinal fluid in a patient with systemic lupus erythematosus. Taiwan J Ophthalmol 2022; 12:472-476. [PMID: 36660116 PMCID: PMC9843574 DOI: 10.4103/2211-5056.362602] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2022] [Accepted: 11/01/2022] [Indexed: 12/11/2022] Open
Abstract
A 28-year-old male patient presented to the outpatient department with visual disturbance in both eyes. The patient had a history of stage IV lupus nephritis that was diagnosed at the age of 14 years and had undergone hemodialysis at the age of 23 years. After he started hemodialysis, the systemic condition was well controlled, and systemic steroids were not used. His best-corrected visual acuity (BCVA) was 20/200 in the right eye and 20/100 in the left eye. Funduscopic examination revealed shallow subretinal fluid (SRF) and serous retinal detachment in both eyes. The first impression of this patient was central serous chorioretinopathy. However, the late phase of fluorescein angiography (FA) demonstrated multiple subretinal leakages, and the late phase of indocyanine green angiography showed choroidal vascular engorgement and multiple hyperfluorescent plaques in both eyes. Systemic lupus erythematosus showed moderate activity according to the results of the systemic evaluation. Based on the clinical examination, lupus choroidopathy was suspected in both eyes. Half-fluence photodynamic therapy (PDT) was administered to both eyes rather than systemic steroids because the patient was systemically stable. Three months after PDT, no SRF was observed in either eye. In addition, multiple subretinal leakages on FA were reduced compared to those before treatment. There was no recurrence of SRF for 4 years after PDT, and the final BCVA was 20/70 in the right eye and 20/40 in the left eye. During this time, numerous hypoautofluorescence spots appeared adjacent to the major retinal vessels in fundus autofluorescence.
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Affiliation(s)
- Jong Beom Park
- Department of Ophthalmology, Kyung Hee University Hospital, Kyung Hee University, Seoul, Korea
| | - Kiyoung Kim
- Department of Ophthalmology, Kyung Hee University Hospital, Kyung Hee University, Seoul, Korea
| | - Min Seok Kang
- Department of Ophthalmology, Kyung Hee University Hospital, Kyung Hee University, Seoul, Korea
| | - Eung Suk Kim
- Department of Ophthalmology, Kyung Hee University Hospital, Kyung Hee University, Seoul, Korea
| | - Seung-Young Yu
- Department of Ophthalmology, Kyung Hee University Hospital, Kyung Hee University, Seoul, Korea,Address for correspondence: Prof. Seung-Young Yu, Department of Ophthalmology, Kyung Hee University Hospital, 23, Kyungheedae-ro, Dongdaemun-gu, Seoul 02447, Korea. E-mail:
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Park JB, Kim K, Kang MS, Kim ES, Yu SY. Central serous chorioretinopathy: Treatment. Taiwan J Ophthalmol 2022; 12:394-408. [PMID: 36660123 PMCID: PMC9843567 DOI: 10.4103/2211-5056.362040] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2022] [Accepted: 10/12/2022] [Indexed: 11/29/2022] Open
Abstract
Central serous chorioretinopathy (CSC) is a pachychoroid spectrum disease characterized by serous detachment of the neurosensory retina with subretinal fluid in young and middle-aged adults. The pathogenesis of CSC is not yet fully understood. However, it is considered a multifactorial disease that is strongly associated with choroidal dysfunction or vascular engorgement. Although there is no consensus on the treatment of CSC, photodynamic therapy has been effectively used to manage serous retinal detachment (SRD) in CSC. Moreover, micropulse diode laser photocoagulation and focal laser treatment have also been used. Recently, oral medications, including mineralocorticoid receptor antagonists, have been proposed for the management of CSC. Multimodal imaging plays a significant role in the diagnosis and treatment of CSC. Optical coherence tomography angiography (OCTA) has the advantage of detecting vascular flow in the retina and choroid layer, allowing for a better understanding of the pathology, severity, prognosis, and chronicity of CSC. In addition, early detection of choroidal neovascularization in CSC is possible using OCTA. This review article aims to provide a comprehensive and updated understanding of CSC, focusing on treatment.
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Affiliation(s)
- Jong Beom Park
- Department of Ophthalmology, Kyung Hee University Hospital, Kyung Hee University, Seoul, Korea
| | - Kiyoung Kim
- Department of Ophthalmology, Kyung Hee University Hospital, Kyung Hee University, Seoul, Korea
| | - Min Seok Kang
- Department of Ophthalmology, Kyung Hee University Hospital, Kyung Hee University, Seoul, Korea
| | - Eung Suk Kim
- Department of Ophthalmology, Kyung Hee University Hospital, Kyung Hee University, Seoul, Korea
| | - Seung-Young Yu
- Department of Ophthalmology, Kyung Hee University Hospital, Kyung Hee University, Seoul, Korea,Address for correspondence: Prof. Seung-Young Yu, Department of Ophthalmology, Kyung Hee University Hospital, 23, Kyungheedae-ro, Dongdaemun-Gu, Seoul 02447, Korea. E-mail:
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Zheng F, He J, Su Z, Liu Y, Xu Y, Liu L, Ye P. OCT biomarkers related to subthreshold micropulse laser treatment effect in central serous chorioretinopathy. BMC Ophthalmol 2022; 22:252. [PMID: 35668416 PMCID: PMC9172075 DOI: 10.1186/s12886-022-02472-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2022] [Accepted: 05/30/2022] [Indexed: 11/17/2022] Open
Abstract
Background To identify the OCT biomarkers related to the anatomical outcomes in eyes with central serous chorioretinopathy (CSCR) after subthreshold micropulse laser (SML) treatment. Methods Patients with CSCR underwent SML were enrolled in this retrospective study. Only patients who underwent enhanced depth imaging optical coherence tomography (EDI-OCT) examination before and after SML were selected. Patients were divided into two groups based on whether subretinal fluid (SRF) absorbed or not after SML. Group 1 was the SRF resolved group, and Group 2 was the SRF non-resolved group. Factors including age and gender, duration of symptoms, CSCR history, the height of SRF at baseline, retinal pigment epithelium (RPE) /inner choroid alterations, as well as subfoveal choroidal thickness (SFCT) of the affected eye and the fellow eye before and after SML were recorded and compared between two groups. Longitudinal change of SFCT of a subgroup of patients were analyzed. Results A total of 58 eyes of 58 patients were involved in this study. SRF of 31 eyes got completely absorbed, and SRF of 27 eyes was retained after SML. Logistic regression analysis revealed baseline SFCT of the affected eye (OR = 1.007, 95% CI: 1.001–1.012, P = 0.019) and RPE/inner choroid alterations (OR = 25.229, 95% CI: 2.890–220.281, P = 0.004) were correlated with SML efficacy. Thirty-three eyes of 33 patients were enrolled in the subgroup analysis. A significant difference of SFCT changes between two groups were demonstrated (P = 0.001). The difference of SFCT between baseline and three months after SML was also related to SRF resolution (OR = 0.952, 95% CI: 0.915–0.990, P = 0.014). Conclusion Baseline SFCT, change of SFCT at 3-month after treatment, and RPE/inner choroid alterations were the OCT biomarkers related to SRF resolution after SML treatment.
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Affiliation(s)
- Fang Zheng
- Eye Center, Second Affiliated Hospital, College of Medicine, Zhejiang University, No.88, Jiefang Road, Hangzhou, 310009, China
| | - Jingliang He
- Eye Center, Second Affiliated Hospital, College of Medicine, Zhejiang University, No.88, Jiefang Road, Hangzhou, 310009, China
| | - Zhitao Su
- Eye Center, Second Affiliated Hospital, College of Medicine, Zhejiang University, No.88, Jiefang Road, Hangzhou, 310009, China
| | - Ye Liu
- Eye Center, Second Affiliated Hospital, College of Medicine, Zhejiang University, No.88, Jiefang Road, Hangzhou, 310009, China
| | - Yufeng Xu
- Eye Center, Second Affiliated Hospital, College of Medicine, Zhejiang University, No.88, Jiefang Road, Hangzhou, 310009, China
| | - Lei Liu
- Guangdong Eye Institute, Department of Ophthalmology, Guangdong Provincial People's Hospital, Guangzhou, China
| | - Panpan Ye
- Eye Center, Second Affiliated Hospital, College of Medicine, Zhejiang University, No.88, Jiefang Road, Hangzhou, 310009, China.
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Shinojima A, Lee D, Tsubota K, Negishi K, Kurihara T. Retinal Diseases Regulated by Hypoxia-Basic and Clinical Perspectives: A Comprehensive Review. J Clin Med 2021; 10:jcm10235496. [PMID: 34884197 PMCID: PMC8658588 DOI: 10.3390/jcm10235496] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2021] [Revised: 11/08/2021] [Accepted: 11/19/2021] [Indexed: 11/16/2022] Open
Abstract
In recent years, the number of patients with age-related macular degeneration (AMD) is increasing worldwide along with increased life expectancy. Currently, the standard treatment for wet-AMD is intravitreal injection of anti-vascular endothelial growth factor (VEGF) drugs. The upstream of VEGF is hypoxia-inducible factor (HIF), a master regulator of hypoxia-responsive genes responsive to acute and chronic hypoxia. HIF activation induces various pathological pro-angiogenic gene expressions including VEGF under retinal hypoxia, ultimately leading to the development of ocular ischemic neovascular diseases. In this regard, HIF is considered as a promising therapeutic target in ocular ischemic diseases. In clinical ophthalmology, abnormal hypofluorescent areas have been detected in the late-phase of indocyanine green angiography, which are thought to be lipid deposits at the level of Bruch’s membrane to choriocapillaris in vitreoretinal diseases. These deposits may interfere with the oxygen and nutrients that should be supplied to the retinal pigment epithelium, and that HIF/VEGF is highly suspected to be expressed in the hypoxic retinal pigment epithelium, leading to neovascularization. In this review, we comprehensively summarize pathophysiology of AMD-related ocular diseases with the HIF/VEGF pathway from basic and clinic researches with recent findings.
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Affiliation(s)
- Ari Shinojima
- Laboratory of Photobiology, Keio University School of Medicine, Tokyo 160-8582, Japan; (A.S.); (D.L.)
- Department of Ophthalmology, Keio University School of Medicine, Tokyo 160-8582, Japan; (K.T.); (K.N.)
| | - Deokho Lee
- Laboratory of Photobiology, Keio University School of Medicine, Tokyo 160-8582, Japan; (A.S.); (D.L.)
- Department of Ophthalmology, Keio University School of Medicine, Tokyo 160-8582, Japan; (K.T.); (K.N.)
| | - Kazuo Tsubota
- Department of Ophthalmology, Keio University School of Medicine, Tokyo 160-8582, Japan; (K.T.); (K.N.)
- Tsubota Laboratory, Inc., Tokyo 160-0016, Japan
| | - Kazuno Negishi
- Department of Ophthalmology, Keio University School of Medicine, Tokyo 160-8582, Japan; (K.T.); (K.N.)
| | - Toshihide Kurihara
- Laboratory of Photobiology, Keio University School of Medicine, Tokyo 160-8582, Japan; (A.S.); (D.L.)
- Department of Ophthalmology, Keio University School of Medicine, Tokyo 160-8582, Japan; (K.T.); (K.N.)
- Correspondence: ; Tel.: +81-3-5313-4132; Fax: +81-3-5363-3274
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Goel N, Mehta A, Gupta AK. Multifocal electroretinography-assisted anatomical and functional evaluation of subthreshold green laser in acute central serous chorioretinopathy. Indian J Ophthalmol 2021; 69:2341-2346. [PMID: 34427217 PMCID: PMC8544059 DOI: 10.4103/ijo.ijo_3401_20] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022] Open
Abstract
Purpose: To compare observation versus subthreshold green laser (STL) in acute central serous chorioretinopathy (CSC) in terms of anatomical and functional outcomes. Methods: Prospective randomized interventional study. 30 eyes with the first episode of acute CSC underwent complete ophthalmologic examination, measurement of best-corrected Snellen visual acuity (BCVA), contrast sensitivity (CS), fundus fluorescein angiography (FFA), spectral-domain optical coherence tomography (SD-OCT), and multifocal electroretinography (mfERG) at baseline. Patients were randomized equally to group A (observation) or group B (STL using 532 nm wavelength applied to the leakage point). Outcome measures included BCVA, CS, central foveal thickness (CFT), and mean macular thickness (MMT) on SD-OCT and P1 amplitude and implicit time (IT) on mfERG. Patients were followed up for 6 months. Results: Mean BCVA was comparable between the two groups on follow up; however, mean CS was significantly higher in group B at 6 months (P = 0.032). CFT was significantly lower in group B at 1 month (P = 0.001) and 3 months (P = 0.049); however, this difference was not maintained at 6 months (P = 0.265). P1 amplitude and IT in all 5 rings were comparable between the two groups at baseline. On follow up, P1 amplitude of ring 1 became significantly higher in group B at 3 months (P = 0.036) and 6 months (P = 0.022). Conclusion: Immediate treatment of acute CSC with STL, as compared to conservative management, leads to more rapid resolution on SD-OCT and superior functional outcomes as evidenced by CS and mfERG.
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Affiliation(s)
- Neha Goel
- Department of Ophthalmology, Max Multi Speciality Centre, New Delhi, India
| | - Aanchal Mehta
- Department of Vitreoretina, ICARE Eye Hospital and Postgraduate Institute, NOIDA, Uttar Pradesh, India
| | - A K Gupta
- Department of Vitreoretina, ICARE Eye Hospital and Postgraduate Institute, NOIDA, Uttar Pradesh, India
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