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Yellow (577 nm) micropulse laser versus half-dose verteporfin photodynamic therapy in eyes with chronic central serous chorioretinopathy: results of the Pan-American Collaborative Retina Study (PACORES) Group
  1. Jose A Roca1,
  2. Lihteh Wu2,
  3. Jans Fromow-Guerra3,4,
  4. Francisco J Rodríguez5,
  5. Maria H Berrocal6,
  6. Sergio Rojas7,
  7. Luiz H Lima8,
  8. Roberto Gallego-Pinazo9,
  9. Jay Chhablani10,
  10. J Fernando Arevalo11,
  11. David Lozano-Rechy12,
  12. Martin Serrano13
  1. 1Clinica Ricardo Palma, Lima, Peru
  2. 2Asociados de Macula Vitreo y Retina de Costa Rica, San Jose, Costa Rica
  3. 3Macula Retina Consultores, Mexico City, Mexico
  4. 4Asociación Para Evitar la Ceguera, Hospital Luis Sanchez Bulnes, Mexico City, Mexico
  5. 5Ophthalmology, Fundación Oftalmológica Nacional, Universidad del Rosario Bogotá, Bogotá, Colombia
  6. 6University of Puerto Rico, San Juan, Puerto Rico
  7. 7Hospital La Luz, Mexico City, Mexico
  8. 8Federal University of Sao Paulo, Sao Paulo, Brazil
  9. 9Hospital La Fe, Universidad de Valencia, Valencia, Spain
  10. 10LV Prasad Institute, Hyderabad, India
  11. 11Wilmer Eye Institute, Johns Hopkins University, Baltimore, Maryland, USA
  12. 12Instituto Oftalmologico Conde de Valenciana, Mexico City, Mexico
  13. 13Clinica Oftalmologica Centro Caracas and the Arevalo-Coutinho Foundation for Research in Ophthalmology, Caracas, Venezuela
  1. Correspondence to Dr Lihteh Wu, Asociados de Macula Vitreo y Retina de Costa Rica, San Jose 10102, Costa Rica; lw65{at}cornell.edu

Abstract

Purpose To compare the functional and anatomical outcomes of eyes with chronic central serous chorioretinopathy treated with yellow micropulse (MP) laser versus half-dose verteporfin photodynamic therapy (PDT).

Methods This is a multicentre, retrospective comparative study of 92 eyes treated with yellow MP laser (duty cycle of 5%, zero spacing between spots, spot size varied from 100 to 200 µm, power varied from 320 to 660 mW, and the pulse burst duration was 200 ms) and 67 eyes treated with PDT (half-dose verteporfin (3 mg/m2) infused over 10 min), followed by laser activation for 83 s. Spot sizes varied from 400 to 2000 µm.

Results In the MP group, at 12 months of follow-up, the mean best corrected visual acuity (BCVA) improved from the logarithm of the minimum angle of resolution (logMAR) of 0.41±0.27 at baseline to 0.21±0.26 (P<0.0001), 48.9% (45/92) of eyes had an improvement of ≥3 lines of BCVA from baseline, 48.9% (45/92) of eyes remained within 2 lines of baseline BCVA, and only 2.2% (2/92) of eyes lost ≥3 lines of BCVA from baseline. In the PDT group, at 12 months of follow-up, the mean BCVA changed from logMAR of 0.50±0.34 at baseline to 0.47±0.34 (P=0.89), 19% (13/67) of eyes had an improvement of ≥3 lines of BCVA from baseline, 73% (49/67) of eyes remained within 2 lines of baseline BCVA, and 7% (5/67) of eyes lost ≥3 lines of BCVA from baseline. There were no adverse events attributable to the yellow MP laser treatment. One eye in the PDT group developed choroidal neovascularisation, which was treated with three intravitreal bevacizumab injections.

Conclusions Both PDT and MP are effective in restoring the macular anatomy. In places where PDT is not available, yellow MP laser may be an adequate treatment alternative.

  • retina
  • treatment lasers
  • macula

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Footnotes

  • Contributors All named authors have contributed in different capacities in the elaboration of the manuscript. All authors contributed to the conception or design of the work, or the acquisition, analysis or interpretation of data; revised the manuscript critically for important intellectual content; approved this manuscript version; and agree to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.

  • Competing interests LW reports personal fees from Quantel Medical, personal fees from Bayer, personal fees from Novartis, outside the submitted work. MHB reports personal fees from Alcon, personal fees from Allergan, outside the submitted work. RG-P reports other from Novartis, outside the submitted work, and reports grants and personal fees from Novartis, grants and personal fees from Roche, personal fees from Heidelberg Engineering, grants from Thea, other from Carl Zeiss Meditec, outside the submitted work. JFA reports personal fees from Springer SBM, personal fees from Turing Pharmaceuticals, personal fees from DORC International BV, personal fees from Allergan, personal fees from Bayer, personal fees from Mallinckrodt, outside the submitted work. JAR, LHL, JC, JF-G, DL-R, SR and MS have nothing to disclose.

  • Ethics approval Clinica Ricardo Palma Lima Peru.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Presented at Presented in part at the 30th Club Jules Gonin Meeting, 8 July 2016, Bordeaux, France, and the 49th Retina Society Meeting, 14 September 2016, San Diego, California, USA.

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