Scientific Online Resource System

Journal of the Union of Scientists - Varna. Medicine and Ecology Series

Subliminal micropulse laser - a new opportunity for treatment of central serous chorioretinopathy

Anna Ilieva, Zornitsa Zlatarova


Introduction: In the last decade, the subliminal micropulse laser has been introduced as an alternative to conventional laser photocoagulation for treatment of retinal diseases. The subliminal micropulse laser does not cause thermal damage to retinal cells. This is extremely important when treatment near the fovea is required.

Aim: The aim of this article is to represent clinical experience described in literature and to share our first impressions after application of subliminal micropulse laser in clinical practice. 

Materials and Methods: Three eyes of three patients were examined. The mean age of the patients was 44.6 years. They were diagnosed with central serous chorioretinopathy. Full eye examination, fluorescein angiography and optical coherent tomography were performed. Treatment with subliminal laser with wavelength 577 nm was conducted. Visual acuity and central macular thickness before and 3 months after treatment were examined.

Results: In 2 eyes we established reduction in the central macular thickness and total resorption of subretinal fluid. In the third patient, subretinal fluid persisted.

Conclusion: Treatment with subliminal micropulse laser is a new opportunity for treatment of retinal diseases, which is quick and safe. In the present study we discovered positive anatomical and functional results.


subliminal micropulse laser, central serous chorioretinoprathy, visual acuity, central macular thickness

Full Text


Bandello F, Lanzetta P, Furlan F, Polito A. Non visible subthreshold micropulse diode laser treatment of idiopathic central serous chorioretinopathy. A pilot study. Invest Ophthalmol Vis Sci. 2003;44:4858

Breukink M.B., Dingemans A.J., den Hollander A.I., Keunen J.E., MacLaren R.E., Fauser S., Querques G., Hoyng C.B., Downes S.M., Boon C.J. Chronic central serous chorioretinopathy: Long-term follow-up and vision-related quality of life. Clin. Ophthalmol. 2016;11:39–46

Cakir B., Reich M., Lang S.J. Possibilities and Limitations of OCT-Angiography in Patients with Central Serous Chorioretinopathy. Klin. Monbl. Augenheilkd. 2017;234:1161–1168

Chen S.N., Hwang J.F., Tseng L.F., Lin C.J. Subthreshold diode micropulse photocoagulation for the treatment of chronic central serous chorioretinopathy with juxtafoveal leakage. Ophthalmology. 2008;115:2229–2234

Dorin G, editor. Subthreshold and micropulse diode laser photocoagulation. Seminars in Ophthalmology. 2003;18(3):147–53

Dorin G. Evolution of retinal laser therapy: minimum intensity photocoagulation (MIP). Can the laser heal the retina without harming it? Semin Ophthalmol. 2004;19(1–2):62–8

Gawęcki M., Jaszczuk-Maciejewska A., Jurska-Jaśko A., Grzybowski A. Functional and morphological outcome in patients with chronic central serous chorioretinopathy treated by subthreshold micropulse laser. Graefes Arch. Clin. Exp. Ophthalmol. 2017;255:2299–2306.

Gawęcki M. Micropulse Laser Treatment of Retinal Diseases. J Clin Med. 2019 Feb 13;8(2):242

Inagaki K., Shuo T., Katakura K., Ebihara N., Murakami A., Ohkoshi K. Sublethal Photothermal Stimulation with a Micropulse Laser Induces Heat Shock Protein Expression in ARPE-19 Cells. J. Ophthalmol. 2015;2015:729792

Koss M.J., Beger I., Koch F.H. Subthreshold diode laser micropulse photocoagulation versus intravitreal injections of bevacizumab in the treatment of central serous chorioretinopathy. Eye. 2012;26:307–314.

Lanzetta P, Dorin G, Pirracchio A, Bandello F. Theoretical bases of non-ophthalmoscopically visible endpoint photocoagulation. Semin Ophthalmol. 2001;16(1):8–11

Lanzetta P, Furlan F, Morgante L, Veritti D, Bandello F. Nonvisible subthreshold micropulse diode laser (810 nm) treatment of central serous chorioretinopathy. A pilot study. Eur J Ophthalmol 2008; 18: 934

Lewen RM. Subretinal neovascularization complicating laser photocoagulation of diabetic maculopathy. Ophthal Surg Lasers Imaging Retina. 1988;19(10):734–737

Meyer-Schwickerath G. Light coagulation. Buech. Augenarzt. 1959;33:

Roider J. Laser treatment of retinal diseases by subthreshold laser effects. Semin Ophthalmol. 2009;14(19–26)

Sliney DH, Wolbarsht ML. Safety with lasers and other optical sources: a comprehensive handbook. New York: Plenum Press, 1980:1035

Ulbig MR, Arden GB, Hamilton AP. Color contrast sensitivity and pattern electroretinographic findings after diode and argon laser photocoagulation in diabetic retinopathy. Am J Ophthalmol. 1994;117(5):583–588

Wong JG, Nguyen TTH. Yellow Pattern 577-nm Micropulse Laser: Treatment of Macular Edema from Radiation Retinopathy - A Case Report. Case Rep Ophthalmol. 2017;8(1):81–86

Yadav NK, Jayadev C, Mohan A, Vijayan P, Battu R, Dabir S, et al. Continuing medical education: subthreshold micropulse yellow laser (577 nm) in chronic central serous chorioretinopathy: safety profile and treatment outcome. Eye (Lond) 2015. February;29(2):258–264

Yan S, Chen Y, Chen R, Tian B, Li Z. Subthreshold micropulse laser photocoagulation therapy in a case of bilateral retinal astrocytic hamartomas with tuberous sclerosis complex: A case report. Medicine (Baltimore). 2018;97(50):e13265



Font Size