Publication:

Micropulse diode laser versus bevacizumab in chronic central serous chorioretinopathy: a pilot study

Background Central serous chorioretinopathy (CSC) is an idiopathic condition with an illdefined aetiopathogenesis and no clearly effective treatment. The choice of treatment include thermal laser photocoagulation, photodynamic therapy (PDT), subthreshold micropulse laser and anti VEGF.

Methods In a prospective nonrandomized pilot trial we evaluated two of these modalities subthreshold micropulse laser treatment and intravitreal anti VEGF in 20 consecutive cases of non-resolving CSC of duration 3 to 6 months with vision below 6/12 treated with either Bevacizumab for leakage close to fovea or subthreshold micropulse 810 diode laser for extrafoveal leakage (10% duty cycle, 100 µ spot size) as seen on fluorescein angiography.

Results At 6 months follow up complete resolution was seen in 9/10 in laser and 6/10 in Avastin group. The mean visual acuity improved from  Log MAR 0.61 ± 0.17  at baseline to Log MAR 0.07± 0.11  post treatment in laser group and from Log MAR 0.59 ± 0.17  to Log MAR 0.18 ± 0.09   in the Avastin group . Similarly mean central macular thickness decreased from 607 µ ± 162.1 to 206 µ ± 55   in laser group and from 601 µ ± 182 to 262 µ ± 75 in those receiving Avastin. Both visual outcome and resolution of serous detachment was better with Micropulse laser as compared to Bevacizumab.

Conclusions Micropulse diode laser treatment of CSC has higher rate of resolution and better visual outcome as compared to Bevacizumab injections.