Comparative Oberservation Of Indirect Laser Photocoagulation And Direct Laser Photocoagulation For Treating Central Serous Chorioretinopathy

BackgroundCentral serous chorioretinopathy(CSC)characterised by serous detachment of the neurosensory retina often affects young men who experience visual disturbances including metamorphopsia,central scotoma,reduced visual acuity and loss of contrast sensivity.Fundus fluorescein angiography(FFA)shows single or multifocal spots of dye leakage at the level of the retinal pigment epithelium(RPE).Indocyanine green angiography often reveals multifocal areas of choroidal vascular hyperpermeability.Optical coherence tomography(OCT)shows detachment of the neurosensory retina and/or of the pigment epithelium.Most episodes of CSC are self-limited and resolvespontaneously within 3-4 months?Laser photocoagulationused to be thefirst choicefor CSC.ObjectiveTo evaluate the clinical effect of indirect laser photocoagulation for central serous chorioretinopathy(CSC).MethodsForty-one patients(42 eyes)with CSC were divided into two groups based on fundus fluorescein angiography(FFA):the observation group whose leakage located at 1/3PD(500?m)near the macula and the control group whose leakage located at 1/3PD(500?m)outside the macula.Twenty eyes of the observation group underwent indirect laser photocoagulation;twenty-two eyes of the control group underwent direct laser photocoagulation.The follow-up period was 3 months.The best corrected visual acuity(BCVA)and fundus and central foveal thickness(CFT)were observed at pre-operation and postoperation 1week,1month,2months,3months and the results were compared.ResultsThe BCVA before treatment in the observation group and control group were 0.59±0.20 and 0.60±0.22,respectively,which after the treatment were 0.90±0.18 and 0.91±0.04,there were statistical differences in the BCVA of pre-operation and postoperation 3 months(all P<0.01).There were no statistical differences in the BCVA of pre-operation and postoperation between two groups(all P>0.05).The postoperative CFT at different time of two groups were all lower than pre-operation(all P<0.01);the CFT of 1 month after treatment of two groups were lower than that of 1 week(all P<0.01),no statistical difference was found among 1month and 2 months and 3 months after treatment(all P>0.05).There were no statistical differences in pre-operative CFT and postoperative CFT at different time between two groups(all P>0.05).Conclusion? Bothindirect and direct laser photocoagulation for CSC could improve symptoms,promoteanatomical reposition of retinal,improve andmaintainvisualacuity.?Indirect laser photocoagulation was suggested to be thefirst choicefor patientswith leakage in ornear macular center.