Assessment of the Efficacy of Photodynamic Therapy in Patients with Chronic Central Serous Chorioretinopathy

Abstract

Purpose: The aim of this prospective clinical study was to evaluate the anatomical and functional results of the treatment of 54 eyes with chronic form of central serous chorioretinopathy (CSC) using photodynamic therapy in a reduced (half) verteporfin (HD-PDT) dosing regimen. Materials and Methods: Our prospective study included 54 eyes of 52 patients (40 males, 12 females) at an average age of 50.1 years (median 49.5, range 30–75 years) treated at the Ophthalmology Clinic of the First Faculty of Medicine and Military University Hospital in Prague from January 2012 to January 2018 for chronic form of CSC with a minimum disease duration of 3 months. In our study, we evaluated the improvement of the best corrected visual acuity (BCVA) and central retinal thickness (CRT) before treatment and at 1, 3, 6 and 12 months after HD-PDT. Results: The mean baseline BCVA was 68.91 ± 10.5 ETDRS letters (median 71; range 35–85) and the mean baseline CRT was 385.6 ± 118.5 µm (median 367, 5 µm; range 245–1000 µm). At the end of the follow-up period, the average BCVA was 79 ± 11 ETDRS letters (median 82; range 38–93). The improvement in BCVA before and after treatment was statistically significant in all measurements (p < 0.0001). The mean CRT at the end of the follow-up period was 263.5 ± 52 µm (median 258.5 µm; range 162–404 µm). The decrease in CRT at all timepoints was statistically significant compared to baseline (p < 0.0001). In our set of patients, at the end of the follow-up period, the retinal finding was improved or stabilized in 50 eyes (92.6 %). In this study, we observed in 2 cases the development of secondary choroidal neovascularization (CNV). Conclusion: HD-PDT is a long-term safe and effective method of treating chronic forms of CSC. However, despite a reduced dose of verteporfin, complications may occur.

Laser Treatment of Central Serous Chorioretinopathy – An Update

“…Compared to other laser options employed in CSCR, PDT provides quite spectacular improvements in retinal morphology. Complete resolution of SRF after PDT is reported in a high percentage of cases, 60 – 90% depending on the study 62 , 64 , 66 , 69 , 71 , 73 , 74 , 76 , 78 , 79 . Similar effects concern CST reduction.…”

“…studies published in the last 5 years report preservation or just minor improvement of BCVA after PDT in chronic CSCR[64,68,70,78,80,81]. More distinct mean visual gain is noted in just a few studies:Feenstra et al by 8 letters [67], Wakatsuki et al [76] by 4.5 letters, and Park et al by 0.15 logMAR…”

“…Similar results concerning the ellipsoid zone were reported by Gobeka et al[87]: preserved integrity of the ellipsoid layer before PDT was directly correlated to BCVA improvement after the proce-Morphological improvementsCompared to other laser options employed in CSCR, PDT provides quite spectacular improvements in retinal morphology. Complete resolution of SRF after PDT is reported in a high percentage of cases, 60-90 % depending on the study[62,64,66,69,71,73,74,76,78,79]. Similar effects concern CST reduction.…”

Central Serous Chorioretinopathy. A Review

“…Redukovaná PDT je díky velmi pozitivním výsledkům a uspokojivému bezpečnostnímu profilu demonstrovaného dosud provedenými klinickými studiemi považována za léčbu první volby, ačkoliv se v indikaci pro CSC jedná o léčbu tzv. off-label [142,143].…”

Retrospective Analysis Of The Presence Of Choroidal Neovascularisation Using Optical Coherence Tomography Angiography In The Treatment Of Chronic Central Serous Chorioretinopathy With The Aid Of Photodynamic Therapy

“…CSC nejčastěji postihuje mladší muže, ale můžeme ji diagnostikovat i u starších pacientů obou pohlaví. Fotodynamická terapie v redukovaném dávkovacím režimu se jeví jako účinná a bezpečná metoda léčby chronické formy centrální serózní chorioretinopatie (cCSC) [3,4,5]. Mezi hlavní diagnostické nástroje patří optická koherenční tomografie (OCT), fluorescenční angiografie (FAG) a indocyaninová angiografie (ICG).…”