Clinical Study
Eye (2008) 22, 100–106; doi:10.1038/sj.eye.6702449; published online 26 May 2006
Transpupillary thermotherapy for subfoveal leaks in central serous chorioretinopathy
D Shukla1, C Kolluru1, T P Vignesh1, S Karthikprakash2 and R Kim1
- 1Retina – Vitreous Service, Aravind Eye Hospital and Postgraduate Institute of Ophthalmology, Madurai, TN, India
- 2Department of Biostatistics, Lions Aravind Institute of Community Ophthalmology, Madurai, TN, India
Correspondence: D Shukla, Aravind Eye Hospital and Postgraduate Institute of Ophthalmology, Retrina – Vitreous Service, No. 1 Anna Nagar, Madurai, TN 625 020, India. Tel: +91 452 5356100; Fax: +91 452 2530984; E-mails: daksh@aravind.org; daksh66@rediffmail.com
Received 31 October 2005; Revised 23 April 2006; Accepted 23 April 2006; Published online 26 May 2006.
Abstract
Aim
To evaluate transpupillary thermotherapy (TTT) for the treatment of subfoveal focal leaks in central serous chorioretinopathy (CSC).
Methods
The patients presenting with long-standing CSC, but without the features of chronicity, were offered the options of TTT, photodynamic therapy (for subfoveal leaks), photocoagulation (for extrafoveal leaks), or observation. The patients who opted for TTT or observation were enrolled in this study. TTT was performed using a spot diameter of 0.5 mm for 1 min. Best-corrected visual acuity (BCVA), status of macular detachment, and fluorescein angiographic status were evaluated at 1, 3, and 6 months.
Results
This study included 39 patients (40 eyes) with CSC between 4 and 12 months, of whom 25 patients (25 eyes) opted for TTT for subfoveal leaks. Fourteen patients (15 eyes) were followed up without treatment. The groups were comparable in age, sex, and baseline BCVA. Minimum follow-up was 6 months. Within 3 months, TTT resulted in the resolution of the serous detachment in 24 (96%) eyes with a single session; one eye required a repeat treatment. Eight control eyes demonstrated persisting CSC at the last follow-up. Visual acuity improved in 23 (92%) treated and five (33%) control eyes; the difference in outcome was statistically significant (P<0.001). One case developed choroidal neovascularization, which resolved with visual recovery to 20/20 after repeat-TTT.
Conclusion
TTT resulted in the resolution of CSC with subfoveal angiographic leaks with significant improvement in visual outcome, in comparison to the natural history of persistent CSC.
Keywords:
transpupillary thermotherapy, subfoveal leak, central serous chorioretinopathy
