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Non Damaging Photothermal Therapy for the Retina

 Topcon Medical Laser Systems announced publication of a study affirming the clinical safety and efficacy of non-damaging photo-thermal therapy for the treatment of chronic central serous retinopathy (CSR) using a pattern-scanning laser (PASCAL) with Endpoint Management (EpM) software, according to a company news release. The study, authored by Daniel Lavinsky, MD (Federal University Rio Grande do Sul), and Daniel Palanker, PhD (Stanford University), titled “Non-damaging Photothermal Therapy of the Retina: Initial Clinical Experience with Chronic Central Serous Retinopathy,” was published in Retina, ePub ahead of print, where the study and authors demonstrated that PASCAL with EpM was safe and improved visual acuity and resolution of subretinal fluid in chronic CSR patients. Furthermore, lack of tissue damage allowed for periodic retreatment without tissue scarring, a notable side effect common with conventional photocoagulation, according to Topcon.

The study included 16 patients and demonstrated when using EpM at 30% energy level, the central macular thickness decreased, on average, from 350μm to 282μm (P=0.004). In 75% of patients the subretinal fluid was completely resolved, and in 25% there was some minimal fluid left. Patients gained, on average, 12 ETDRS letters in best corrected visual acuity at 2 months, which remained steady by 6 months of the follow-up (P<0.001). There were no adverse events related to the treatment, and no signs of any damage could be detected either by clinical observation, optical coherence tomography (OCT), fundus autofluorescence (FAF) or fluorescein angiography (FA). Similarly, there was no cumulative damage to the retina after the second or third treatment, with the exception of Landmarks, intentionally placed barely visible burns in the pattern as visual outlines of the treated area.

“This is the first clinical study validating pattern-scanning laser with Endpoint Management for central serous retinopathy, and it was encouraging to see these results,” Daniel Lavinsky, MD, said in a company news release. “We saw excellent treatment results with no adverse side effects or damage to the retina, establishing the technology’s efficacy and favorable safety profile. This clinical study builds on our investigations of the heat shock protein expression after non-damaging laser therapy, and also highlights the role of the thermal stress in resolution of the CSR. Since non-damaging treatment is so efficient, conventional photocoagulation may eventually be considered overtreatment. We’re thrilled with the results of our study now published in Retina.”

“While traditional laser coagulation can help in treatment of macular diseases, it leaves the tissue damaged, which makes future retreatment difficult or impossible,” said Daniel Palanker, PhD. “Being able to treat the retina without any damage is critical, especially for chronic diseases that require periodic retreatments. Equally critical is being able to treat patients consistently, preserving their vision while demonstrating long-lasting therapeutic benefits. 

The article was digitally published ahead of print and the abstract is available and can be viewed here at pubmed