Efficacy of Focal Lasers in Central Serous Chorioretinopathy

AIM OF THE STUDY: To evaluate the efficacy of focal laser in patients diagnosed as CSR with extrafoveal leakage, in terms of visual acuity and central macular thickness and comparing it with the control group. MATERIALS AND METHODS: 60 patients diagnosed as Central Serous Chorioretinopathy attending Uvea and Retina services of RIOGOH, satisfying our inclusion and exclusion criteria were included in the study. All patients underwent detailed history taking and ophthalmic examination including fundus examination along with Fundus Fluorescein Angiography and Optical coherence tomography. Patients were divided into two groups by simple randomization with 30 patients in each group. The patients in the laser group underwent focal laser wherein pinpoint leaks were treated with burns of spot size 100 μm, power of 100 mW of 100 ms duration with 3 confluent burns. The patients of both the groups were followed up at 4 weeks and 12 weeks, to look for the improvement in Best Corrected visual acuity (BCVA) and reduction in the central macular thickness (CMT). RESULTS: The reduction in the CMT of the laser group and the control group were 38.3% and 25.3% respectively at the end of 4 weeks. At the end of 12 months the reduction in the mean CMT was 37.3% in the control group whereas it was 49% in the study group. The BCVA (logMAR)improved from 0.5 at the time of presentation to 0.2 at 4 weeks and 0.1 at six weeks in the laser group and in the control group the BCVA had improved only to 0.43 at 4 weeks and 0.2 at 12 weeks. Mental stress, type A personality and sleep disorders are found to be significant risk factors in patients with CSR in our study. Systemic steroid usage is found to be a significant risk factor in patients with bilateral CSR. The most common site of extrafoveal leakage in fundus flourescein angiography in our study was found to be in the superonasal quadrant (40%). The ink blot pattern was found to be most common pattern in fundus flourescein angiography (present in 65% of the patient). CSR was found to be associated with Retinal Pigment Epithelial. CONCLUSION: Focal lasers are effective in cases of central serous chorioretinopathy which persists for a period of more than three months. Focal lasers can be used effectively to shorten the duration of the disease and results in the resolution of the subretinal fluid and improvement in visual acuity significantly by 4 weeks.