The Role of Imaging in Planning Treatment for Central Serous Chorioretinopathy

Development of a Computer System for Automatically Generating a Laser Photocoagulation Plan to Improve the Retinal Coagulation Quality in the Treatment of Diabetic Retinopathy

In this article, the development of a computer system for high-tech medical uses in ophthalmology is proposed. An overview of the main methods and algorithms that formed the basis of the coagulation plan planning system is presented. The system provides the formation of a more effective plan for laser coagulation in comparison with the use of existing coagulation techniques. An analysis of monopulse- and pattern-based laser coagulation techniques in the treatment of diabetic retinopathy has shown that modern treatment methods do not provide the required efficacy of medical laser coagulation procedures, as the laser energy is nonuniformly distributed across the pigment epithelium and may exert an excessive effect on parts of the retina and anatomical elements. The analysis has shown that the efficacy of retinal laser coagulation for the treatment of diabetic retinopathy is determined by the relative position of coagulates and parameters of laser exposure. In the course of the development of the computer system proposed herein, main stages of processing diagnostic data were identified. They are as follows: the allocation of the laser exposure zone, the evaluation of laser pulse parameters that would be safe for the fundus, mapping a coagulation plan in the laser exposure zone, followed by the analysis of the generated plan for predicting the therapeutic effect. In the course of the study, it was found that the developed algorithms for placing coagulates in the area of laser exposure provide a more uniform distribution of laser energy across the pigment epithelium when compared to monopulse- and pattern-based laser coagulation techniques.

A Review of Central Serous Chorioretinopathy: Clinical Presentation and Management

Central serous chorioretinopathy (CSC) may be understood as a disease of the chorioretina with the serous detachment of the neurosensory retina, which is secondary to single or multiple localized defects in retinal pigment epithelium (RPE). CSC is one of the common forms of loss of vision, usually seen in people who do belong to the working-age group. The most common symptoms are blurring of vision, usually unilateral and which is perceived as a scotoma in the center of the field of vision with associated metamorphopsia and micropsia. The risk factor associated with CSC is psychosocial stress, type A personality, pregnancy, and hypercortisolism. Normal vision is often restored within a span of a few months. After around three months, if the resolution of acute CSC did not change or, let us say, in the case of CSC that is chronic, one should consider treatment. In acute CSC, to resolve symptoms, especially in individuals who work in a field where eyesight is of utmost importance, for example, pilots, focal photocoagulation of leaking RPE lesions can be performed. CSC is a prototype cause of serous neuroretinal detachment, which involves the fovea. CSC symptoms reflect the separation between the RPE and the photoreceptors and the bullous distension of the foveal retina. The effect of therapy as such on the long-term outcome of vision visual is not sufficiently documented. The management would largely be dependent on the appropriate diagnosis made based on clinical presentations, and thus it becomes very much necessary to have knowledge about the same and counsel the patient regarding the association between stress and disease pathology. In acute CSC, retinal photocoagulation is successful to a good extent in eliminating or reducing the leakage of RPE and hence it induces resolution of the serous detachment. This review article is made to make sure the reader is updated about the various clinical and management aspects of CSC by providing a comprehensive idea that is obtained from various well-acknowledged databases across the globe on CSC.