SUBTHRESHOLD LASER TREATMENT FOR SEROUS RETINAL DETACHMENT IN DOME-SHAPED MACULA ASSOCIATED WITH PATHOLOGIC MYOPIA

Purpose: To evaluate the effects of the subthreshold laser treatment as a therapeutic option in the treatment of serous retinal detachment secondary to dome-shaped macula. Methods: Prospective pilot study with 12-month follow-up. Each patient underwent a complete ophthalmologic examination, including best-corrected visual acuity, fluorescein angiography, indocyanine green angiography, and spectral domain optical coherence tomography. Eyes with persistent serous retinal detachment lasting for a minimum of 12 months and absence of best-corrected visual acuity improvement underwent subthreshold laser treatment in a single session. The laser spots were delivered in a contiguous mode, covering the area of hyperfluorescence recognized on indocyanine green angiography. The primary outcome measure was the best-corrected visual acuity changes at the 12-month examination. Secondary outcomes included changes in central foveal thickness (CFT) and number of eyes achieving a complete serous retinal detachment resolution. Results: Twelve eyes (8 patients) were included in the study. Best-corrected visual acuity changed from a baseline value of 0.8 +/- 0.2 (+/- SD, logarithm of the minimum angle of resolution [Snellen equivalent: 20/125]) to 0.48 +/- 0.1 (Snellen equivalent: 20/60, P = 0.001). Central foveal thickness decreased from 320 +/- 52 mu m to a final value of 266 +/- 41 mu m (P = 0.001). Serous retinal detachment reduced in all cases; however, just one eye (8.3%) showed a complete resolution at the 12-month examination. Fluorescein angiography and indocyanine green angiography showed that the hyperfluorescence had disappeared after subthreshold laser treatment. No adverse event was registered, including enlargement of atrophic alterations and choroidal neovascularization. Conclusion: Subthreshold laser treatment can lead to improvements in visual acuity and central foveal thickness in myopic eyes with serous retinal detachment secondary to dome-shaped macula. Further studies are required to confirm our preliminary results.