Purpose:

We use an individualized treatment for CSC based both on traditional procedures and on experimental ones. Laser stimulation therapy can be beneficial even in cases without the typical focus of leakage. In difficult cases without any defined or even anticipated leakage we use experimental therapy with anti-VEGF injections. Even intensive topical steroid therapy, usually strictly rejected, proved to be useful in rare cases.

Methods:

A group of 88 patients with diagnosed CSC included various, very different findings. We excluded 20 eyes which healed spontaneously within several months and also 5 eyes where the finding was questionable and it more reminded AMD. We treated 30 eyes where the focus was clearly defined with focal laser, even in eyes where the focus was juxtafoveal:  here we used threshold energy. In 9 eyes in which the focus could not be clearly defined, we used threshold or subthreshold laser into the anticipated focus. In 13 eyes with multiple leakage or diffuse leakage we used a „stimulation laser“ in the areas of leakage, believing in the activation of the RPE leading to the sealing of the area of leakage. In 6 cases we first tried topical steroid drops in an intensive mode of application, i.e. every hour within one to two weeks, or Avastin, Triamcinolone, or Eylea injections.

Results:

The laser treatment was followed with a complete recovery not only in cases of focal treatment of the leakage point but also in the eyes with very chronic (even lasting seven years) leakage from undefined site. Steroid drops as a monotherapy also helped with healing of two patients but neither Avastin, nor Eylea and Triamcinolone did not bring a convincing effect.

Conclusion:

CSC can be treated with laser not only in cases with clearly focal leakage but even in cases with poorly defined; only anticipated or diffuse leakage.

Contact Details:

Email: fiser@lexum.cz
Cell Phone: +420775203219

Ivan Fiser