Photodynamic therapy and subthreshold micropulse laser treatment – A novel combined approach for the treatment of serous retinal detachment in dome-shaped macula

•Serous retinal detachment is a common complication of dome-shaped macula (DSM).•There is no validated therapy leading to serous retinal detachment resolution in DSM.•A combined new treatment, using PDT and micropulse laser treatment, is reported.•Half-fluence half-dose PDT reduces the risk of chori...

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Vydané v:	Photodiagnosis and photodynamic therapy Ročník 31; s. 101895
Hlavní autori:	Pirani, Vittorio, Pelliccioni, Paolo, Giovannini, Alfonso, Nicolai, Michele, Cesari, Claudia, Mariotti, Cesare
Médium:	Journal Article
Jazyk:	English
Vydavateľské údaje:	Netherlands Elsevier B.V 01.09.2020
Predmet:	Dome-shaped macula Fluorescein Angiography Follow-Up Studies Humans Lasers Optical coherence tomography Pathologic myopia Photochemotherapy - methods Photodynamic therapy Photosensitizing Agents - therapeutic use Retinal Detachment - diagnosis Retinal Detachment - therapy Retrospective Studies Serous retinal detachment Subthreshold micropulse laser Tomography, Optical Coherence Photodynamic therapy Pathologic myopia Optical coherence tomography Dome-shaped macula Subthreshold micropulse laser Serous retinal detachment
ISSN:	1572-1000, 1873-1597, 1873-1597
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Abstract	•Serous retinal detachment is a common complication of dome-shaped macula (DSM).•There is no validated therapy leading to serous retinal detachment resolution in DSM.•A combined new treatment, using PDT and micropulse laser treatment, is reported.•Half-fluence half-dose PDT reduces the risk of chorioretinal atrophy.•Visual and anatomical outcomes of a safe and effective combined therapy are reported. Dome-shaped macula (DSM) is characterized by an inward convexity of the macula in myopic eyes, as visualized on optical coherence tomography (OCT). Serous retinal detachment (SRD) is a common complication of DSM, leading to a deterioration of visual acuity, in association with retinal pigment epithelium (RPE) atrophic changes. Many different therapeutic approaches to SRD secondary to DSM have been attempted, with variable results. We report our experience (11 treatment-naïve patients) with a combined new treatment approach, using half-fluence and half-dose photodynamic therapy (PDT) followed by subthreshold 577 nm micropulse laser treatment (STLT), for SRD related to DSM after a 6-month follow-up. Central foveal thickness was significantly decreased at the end of the follow-up. SRD diminished in all cases, and 5 eyes (45.4 %) registered complete resolution at the end of the 6-month follow-up, while 6 eyes (54.5 %) experienced two lines of improvement in BCVA at the end of the follow-up. No case showed postoperative complications. Therefore, this represents the first study evaluating the visual and anatomical outcomes of a safe and effective combined treatment of SRD in DSM.
AbstractList	Dome-shaped macula (DSM) is characterized by an inward convexity of the macula in myopic eyes, as visualized on optical coherence tomography (OCT). Serous retinal detachment (SRD) is a common complication of DSM, leading to a deterioration of visual acuity, in association with retinal pigment epithelium (RPE) atrophic changes. Many different therapeutic approaches to SRD secondary to DSM have been attempted, with variable results. We report our experience (11 treatment-naïve patients) with a combined new treatment approach, using half-fluence and half-dose photodynamic therapy (PDT) followed by subthreshold 577 nm micropulse laser treatment (STLT), for SRD related to DSM after a 6-month follow-up. Central foveal thickness was significantly decreased at the end of the follow-up. SRD diminished in all cases, and 5 eyes (45.4 %) registered complete resolution at the end of the 6-month follow-up, while 6 eyes (54.5 %) experienced two lines of improvement in BCVA at the end of the follow-up. No case showed postoperative complications. Therefore, this represents the first study evaluating the visual and anatomical outcomes of a safe and effective combined treatment of SRD in DSM. •Serous retinal detachment is a common complication of dome-shaped macula (DSM).•There is no validated therapy leading to serous retinal detachment resolution in DSM.•A combined new treatment, using PDT and micropulse laser treatment, is reported.•Half-fluence half-dose PDT reduces the risk of chorioretinal atrophy.•Visual and anatomical outcomes of a safe and effective combined therapy are reported. Dome-shaped macula (DSM) is characterized by an inward convexity of the macula in myopic eyes, as visualized on optical coherence tomography (OCT). Serous retinal detachment (SRD) is a common complication of DSM, leading to a deterioration of visual acuity, in association with retinal pigment epithelium (RPE) atrophic changes. Many different therapeutic approaches to SRD secondary to DSM have been attempted, with variable results. We report our experience (11 treatment-naïve patients) with a combined new treatment approach, using half-fluence and half-dose photodynamic therapy (PDT) followed by subthreshold 577 nm micropulse laser treatment (STLT), for SRD related to DSM after a 6-month follow-up. Central foveal thickness was significantly decreased at the end of the follow-up. SRD diminished in all cases, and 5 eyes (45.4 %) registered complete resolution at the end of the 6-month follow-up, while 6 eyes (54.5 %) experienced two lines of improvement in BCVA at the end of the follow-up. No case showed postoperative complications. Therefore, this represents the first study evaluating the visual and anatomical outcomes of a safe and effective combined treatment of SRD in DSM. Dome-shaped macula (DSM) is characterized by an inward convexity of the macula in myopic eyes, as visualized on optical coherence tomography (OCT). Serous retinal detachment (SRD) is a common complication of DSM, leading to a deterioration of visual acuity, in association with retinal pigment epithelium (RPE) atrophic changes. Many different therapeutic approaches to SRD secondary to DSM have been attempted, with variable results. We report our experience (11 treatment-naïve patients) with a combined new treatment approach, using half-fluence and half-dose photodynamic therapy (PDT) followed by subthreshold 577 nm micropulse laser treatment (STLT), for SRD related to DSM after a 6-month follow-up. Central foveal thickness was significantly decreased at the end of the follow-up. SRD diminished in all cases, and 5 eyes (45.4 %) registered complete resolution at the end of the 6-month follow-up, while 6 eyes (54.5 %) experienced two lines of improvement in BCVA at the end of the follow-up. No case showed postoperative complications. Therefore, this represents the first study evaluating the visual and anatomical outcomes of a safe and effective combined treatment of SRD in DSM.Dome-shaped macula (DSM) is characterized by an inward convexity of the macula in myopic eyes, as visualized on optical coherence tomography (OCT). Serous retinal detachment (SRD) is a common complication of DSM, leading to a deterioration of visual acuity, in association with retinal pigment epithelium (RPE) atrophic changes. Many different therapeutic approaches to SRD secondary to DSM have been attempted, with variable results. We report our experience (11 treatment-naïve patients) with a combined new treatment approach, using half-fluence and half-dose photodynamic therapy (PDT) followed by subthreshold 577 nm micropulse laser treatment (STLT), for SRD related to DSM after a 6-month follow-up. Central foveal thickness was significantly decreased at the end of the follow-up. SRD diminished in all cases, and 5 eyes (45.4 %) registered complete resolution at the end of the 6-month follow-up, while 6 eyes (54.5 %) experienced two lines of improvement in BCVA at the end of the follow-up. No case showed postoperative complications. Therefore, this represents the first study evaluating the visual and anatomical outcomes of a safe and effective combined treatment of SRD in DSM.
ArticleNumber	101895
Author	Pirani, Vittorio Nicolai, Michele Giovannini, Alfonso Mariotti, Cesare Pelliccioni, Paolo Cesari, Claudia
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Cites_doi	10.1097/IAE.0000000000001524 10.1007/s12325-017-0559-y 10.1007/s00417-019-04449-1 10.1097/IAE.0000000000001138 10.1038/s41598-019-46515-y 10.1016/j.ajo.2010.08.014 10.1016/j.ajo.2008.01.012 10.3928/23258160-20150213-15 10.1016/j.ajo.2014.09.026
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Keywords	Photodynamic therapy Pathologic myopia Optical coherence tomography Dome-shaped macula Subthreshold micropulse laser Serous retinal detachment
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SubjectTerms	Dome-shaped macula Fluorescein Angiography Follow-Up Studies Humans Lasers Optical coherence tomography Pathologic myopia Photochemotherapy - methods Photodynamic therapy Photosensitizing Agents - therapeutic use Retinal Detachment - diagnosis Retinal Detachment - therapy Retrospective Studies Serous retinal detachment Subthreshold micropulse laser Tomography, Optical Coherence
Title	Photodynamic therapy and subthreshold micropulse laser treatment – A novel combined approach for the treatment of serous retinal detachment in dome-shaped macula
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