Navigated 577-nm subthreshold micropulse retinal laser treatment for peripapillary pachychoroid syndrome

Claudio Iovino; Valentina Di Iorio; Laura Paolercio; Cesira Giordano; Francesco Testa; Francesca Simonelli

doi:10.1016/j.ajoc.2022.101757

Navigated 577-nm subthreshold micropulse retinal laser treatment for peripapillary pachychoroid syndrome

Am J Ophthalmol Case Rep. 2022 Nov 21:28:101757. doi: 10.1016/j.ajoc.2022.101757. eCollection 2022 Dec.

Authors

Claudio Iovino¹, Valentina Di Iorio¹, Laura Paolercio¹, Cesira Giordano¹, Francesco Testa¹, Francesca Simonelli¹

Affiliation

¹ Eye Clinic, Multidisciplinary Department of Medical, Surgical and Dental Sciences, University of Campania Luigi Vanvitelli, Naples, Italy.

Abstract

Purpose: To report a case of peripapillary pachychoroid syndrome (PPS) successfully treated with navigated subthreshold micropulse laser (SML).

Observations: A 65-year-old male was referred to our retina service complaining a worsening vision in the left eye (LE) over the past 6 months. A complete ophthalmological evaluation including best corrected visual acuity (BCVA) measurement, spectral-domain optical coherence tomography (SD-OCT) and fluorescein angiography (FA) was performed. SD-OCT showed a thicker nasal choroid and peripapillary intraretinal cysts in both eyes, and macular subretinal fluid (SRF) in the LE. FA illustrated a bilateral peripapillary hyperfluorescent areas, with some macular focal leaking points in the left eye. A diagnosis of PPS was made, and considering the worldwide shortage of verteporfin, Navigated 577-nm SML was performed in the LE on the leaking areas shown on the FA. At the 3- and 6- months follow-up the SRF reabsorbed and BCVA improved from 20/32 to 20/20.

Conclusions and importance: SML can be considered an efficacious treatment option in patients with PPS. Prospective studies with longer follow-up in a bigger cohort are needed to confirm the optimal treatment strategy in PPS.

Keywords: Choroid; Micropulse laser; Pachychoroid spectrum; Peripapillary pachychoroid syndrome.

Publication types

Case Reports