Retinal Diseases
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Laser treatment for retinal stress
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Central serous chorioretinopathy is an eye disease which primarily affects middle-aged people. It involves the collection of fluid under the retina. If this does not revert spontaneously, visual disturbances occur. The illness will then require treatment.
Quick facts:
Triggers and causes of central serous chorioretinopathy
No specific cause is known. In addition, stress and, under certain circumstances, treatments with cortisone are typical triggers. Men aged between 20 and 50 are the most commonly affected.
In central serous chorioretinopathy, a leak appears in Bruch’s membrane, the layer separating the retina and the choroid. Fluid from the choroid flows through this into the retina and causes it to swell. This leads to insufficient supply to the nerve cells. The cells can then die, therefore causing vision problems.
Forms of central serous chorioretinopathy
A distinction is made between acute and chronic forms of central serous chorioretinopathy.
It is primarily young men who are affected by the acute form. In these patients, changes go back easily. This happens within a few weeks or months. Vision is slightly impaired. Visual disturbances are temporary, except in rare cases. Repeat flare-ups may occur, however.
If the illness does not go away spontaneously, it is known as chronic CSCR. It keeps coming back. Loss of sight is a rare outcome. However, lasting visual impairment can occur in severe cases.
Symptoms & Course
In general, the progression of central serous chorioretinopathy is painless. Initially, glare effects occur as typical symptoms. They usually only affect one eye, but do not subside. These are accompanied later by distortions in the middle of the field of view. Depending on the location and size of the swelling, there may also be spots or rings. These become particularly pronounced when working in semi-darkness or when squinting. In very advanced stages, low-contrast or even gray areas can arise. The disease normally heals within a few weeks. If not, treatment measures must be taken.
Symptoms:
- Glare effects
- Image distortions
- Spots or rings
- Loss of contrast
- Disturbed color vision
Diagnosis
Firstly, your ophthalmologist will examine the retina with the slit lamp. He may find swelling of the macula. An angiography is then performed to investigate its origin. For this purpose, a dye is injected into a vein in the arm. This helps to find the leakage source in the choroidal tissue. “Optical coherence tomography” (OCT) is also often recommended. It allows the individual layers of the retina to be depicted. This improves check-ups over the course of treatment.
Treatment
In many cases, the disease heals by itself after a month. Several factors must be taken into account with self-healing. These include abstinence from smoking and avoiding medications containing cortisone. Reducing stress can also help. If no improvement occurs after a few weeks, treatment may be considered.
At present, there is no tried-and-tested “standard treatment”. Medications are often used as a first approach. These are often not entirely successful, however. Further treatment approaches may be employed in such cases. A frequently used treatment is photodynamic therapy. In this case, a medication is injected into a vein and activated via a light source in the eye. Another option is the injection of what is called a VEGF inhibitor directly into the eyeball.
The use of a microsecond pulsing laser is also an option. It protects the surrounding tissue and activates healing. Although the precise mechanism of action is not yet understood, clinical studies have displayed good outcomes. Navilas® provides the ophthalmologist with specific support in this treatment. Thus, even if effects are invisible to him, laser spots can be applied precisely and evenly with the option of digital documentation for easy traceability.
Laser coagulation may be recommended for severe disease and leakages outside the area of sharpest vision. This obliterates the point where the leakage is found. A small scar develops on the retina.
With conventional laser systems, this type of therapy is a challenge that is only considered as an option in a small number of cases. With the Navilas system navigation, it is possible to precisely localize and position the laser on the point of the leakage. This can significantly minimize impairments.