Short-pulse laser plus subthreshold diffuse laser for serous retinal detachment in dome-shaped macula

Murilo Wendeborn Rodrigues; Thais Bastos; Annelise Nicotti Gonçalves; José Augusto Cardillo; André Messias; Eduardo Cunha de Souza; Rodrigo Jorge

doi:10.1186/s40942-023-00483-8

Short-pulse laser plus subthreshold diffuse laser for serous retinal detachment in dome-shaped macula

Int J Retina Vitreous. 2023 Sep 1;9(1):53. doi: 10.1186/s40942-023-00483-8.

Authors

Murilo Wendeborn Rodrigues¹, Thais Bastos², Annelise Nicotti Gonçalves², José Augusto Cardillo³, André Messias², Eduardo Cunha de Souza⁴, Rodrigo Jorge²

Affiliations

¹ Division of Ophthalmology, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, SP, Brazil. murilowrj@yahoo.com.br.
² Division of Ophthalmology, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, SP, Brazil.
³ Department of Ophthalmology, CRESEP Institution, Araraquara, Brazil.
⁴ Department of Ophthalmology, University of São Paulo, São Paulo, Brazil.

Abstract

Background: First described by Gaucher and associates in 2008, dome-shaped macula (DSM) is an anterior convex protrusion of the macula visible on OCT (optical coherence tomography). Visual impairment in DSM results mainly from sub-foveal serous retinal detachment (SRD). Herein, this original study from retrospective data analysis evaluate the anatomical and functional effects of Pascal^® short-pulse (SP) laser plus endpoint management (EpM) subthreshold diffuse laser (SDL) in patients with SRD due to DSM.

Methods: This retrospective study included seven consecutive patients (eight eyes) with SRD secondary to dome-shaped macula who underwent a comprehensive ophthalmological evaluation including logMAR BCVA, slit-lamp biomicroscopy, indirect ophthalmoscopy, and spectral-domain optical coherence tomography (SD-OCT) (Spectralis; Heidelberg Engineering, Germany) before combined Pascal^® SP laser plus EpM-SDL with 1 to 6 month intervals, postoperatively, with a mean ± standard error (SE) follow-up time of 12.92 ± 1.34 months.

Results: Eight eyes from seven patients were analyzed in this study. At baseline, mean BCVA (LogMAR) ± standard error (SE) and mean CST (central subfield thickness)(µm) ± SE were 0.6125 ± 0.14 and 412.50 ± 24.65, respectively. After a mean follow-up time of 12.92 ± 1.34 months, mean CST (µm) ± SE and BCVA (LogMAR) ± SE were 294.75 ± 19.68 (p = 0.0078) and 0.4537 ± 0.12 (p = 0.0313), respectively. A statistically significant reduction in mean CST and an improvement in mean BCVA were noted after SRD resolution with laser therapy application. The mean serous retinal detachment resolution time (months) ± SE was 3.75 ± 1.08. No adverse events were registered, including enlargement of atrophic alterations and choroidal neovascularization.

Conclusions: The novel combined laser modality with Pascal^® SP laser plus EpM-SDL treatment may induce subretinal fluid regression and BCVA improvement 1 year after treatment in DSM patients with SRD.

Keywords: Dome-shaped macula; Short-pulse laser; Subthreshold diffuse laser.