Comparing effects of photodynamic therapy in central serous chorioretinopathy: full-dose versus half-dose versus half-dose-half-fluence

Park, Wookyung; Kim, Min-Ju; Kim, Rae Young; Park, Young-Hoon

doi:10.1007/s00417-019-04426-8

Cited by 29 publications

(32 citation statements)

References 24 publications

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“…We propose that reduction in SA and volume may result from the resolution of exudate and inflammation. 47,48 In contrast to previous studies that have reported a reduction in CVI after vPDT, 27 we found a small increase in CVI of around 6.5%. The CVI is calculated as a proportion of the vascular component to the overall choroid volume.…”

Section: Discussioncontrasting

confidence: 99%

Choroidal and Retinal Changes After Systemic Adrenaline and Photodynamic Therapy in Non-Human Primates

Cheong

Barathi

Teo

et al. 2021

Invest. Ophthalmol. Vis. Sci.

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To determine the tomographic, angiographic, and histologic changes in the choroid and retina of cynomolgus monkeys after systemic adrenaline and verteporfin photodynamic therapy (vPDT). METHODS. Six cynomolgus monkeys (12 eyes) were treated with vPDT only (n = 2), adrenaline only for eight weeks (n = 2), adrenaline for eight weeks with vPDT at week 4 (n = 4), and adrenaline for 12 weeks and vPDT at week 8 (n = 4). Spectral-domain optical coherence tomography, angiography, and autofluorescence were performed at baseline and every 14 days thereafter until 28 days after adrenaline therapy or vPDT. Choroid parameters included choroidal thickness (CT) changes and structural changes using semiautomated image binarization. Histology with light and electron microscopy was performed. RESULTS. Adrenaline resulted in subfoveal CT increase at week 4 compared with baseline (3.4%, P = 0.010), with further increase at week 8 (3.9%, P = 0.007). This correlated with choroidal luminal area increase (16.0% at week 8 compared with baseline, P = 0.030). Outer retinal changes included subretinal fluid, ellipsoid zone (EZ) disruption, photoreceptor elongation, and sub/intraretinal bright dots. Hypocyanescent spots surrounded by leakage was observed. Histology showed dilated choroidal vessels, intracytoplasmic vacuoles, and retinal pigment epithelium (RPE) enlarged basal infoldings. The vPDT decreased subfoveal CT at four weeks after vPDT (−7.5%, P = 0.007). This correlated with choroidal stromal area decrease (−18.0%, P < 0.010). Within the treatment spot, there was outer retinal atrophy, EZ disruption, irregular RPE thickening, intense hypoautofluorescence, hyperfluorescence, and hypocyanescence. On histology, there were outer retina, RPE, and choroid changes. CONCLUSIONS. Adrenaline induces choroidal vessel dilation and CT increase. The vPDT decreases CT because of a reduction in choroidal stromal component.

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Section: Discussioncontrasting

confidence: 99%

Choroidal and Retinal Changes After Systemic Adrenaline and Photodynamic Therapy in Non-Human Primates

Cheong

Barathi

Teo

et al. 2021

Invest. Ophthalmol. Vis. Sci.

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“…The superior anatomical and functional outcome of half-dose PDT in comparison to HSML treatment may therefore not be correlated with changes in CVI. Park et al reported a significant decrease in CVI after half or full-dose PDT, and a significant increase in CVI after half-dose-half-fluence PDT [34]. This is in contrast with our study, since no significant changes in CVI were observed after half-dose PDT.…”

Section: Discussioncontrasting

confidence: 99%

Prospective evaluation of changes in choroidal vascularity index after half-dose photodynamic therapy versus micropulse laser treatment in chronic central serous chorioretinopathy

Rijssen

Singh

Dijk

et al. 2020

Graefes Arch Clin Exp Ophthalmol

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Purpose To assess whether treatment of chronic central serous chorioretinopathy (cCSC) with photodynamic therapy (PDT) and high-density subthreshold micropulse laser (HSML) results in choroidal vascularity index (CVI) changes that may account for the treatment effect. Methods Patients with cCSC were prospectively included and analyzed. Patients received either half-dose PDT or HSML treatment. CVI of the affected and unaffected eye was obtained before treatment, 6 to 8 weeks after treatment, and 7 to 8 months after treatment. Results At baseline, 29 eyes (29 patients) were included both in the PDT and in the HSML group. The mean (± standard deviation) CVI change in the HSML group between before PDT and 6 to 8 weeks after PDT was − 0.009 ± 0.032 (p = 0.127), whereas this was 0.0025 ± 0.037 (p = 0.723) between the visit before PDT and final visit. The patients in the PDT group had a CVI change of − 0.0025 ± 0.037 (p = 0.723) between the visit before PDT and first visit after PDT, and a mean CVI change of − 0.013 ± 0.038 (p = 0.080) between the visit before PDT and final visit. There was no significant correlation between CVI and BCVA at the measured time points, in both the HSML group (p = 0.885), and in the PDT group (p = 0.904). Moreover, no significant changes in CVI occurred in the unaffected eye at any time point. Conclusions PDT and HSML do not significantly affect CVI, and therefore a CVI change may not be primarily responsible for the treatment effect. The positive treatment effect of both interventions may rely on other mechanisms, such as an effect on choriocapillaris and/or retinal pigment epithelium function.

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“…The reduction of subfoveal CT after PDT was statistically significant in all three groups. The results of this study suggest that the effect of PDT on the half-dose half-fluence group was less clear than in the other groups [47]. Three-dimensional CVI was evaluated in treatment-naïve eyes with acute CSC by means of SS-OCT [48].…”

Section: In Pachychoroid Disease Spectrummentioning

confidence: 81%

“…Recently, CVI has been used to evaluate the treatment response in patients with CSC [46,47]. In particular, Rasheed et al compared the effect of laser photocoagulation or observation on the choroidal vasculature in acute CSC [46].…”

Section: In Pachychoroid Disease Spectrummentioning

confidence: 99%

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Choroidal Vascularity Index: An In-Depth Analysis of This Novel Optical Coherence Tomography Parameter

Iovino

Pellegrini

Bernabei

et al. 2020

JCM

168

128

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Remarkable improvements in optical coherence tomography (OCT) technology have resulted in highly sophisticated, noninvasive machines allowing detailed and advanced morphological evaluation of all retinal and choroidal layers. Postproduction semiautomated imaging analysis with dedicated public-domain software allows precise quantitative analysis of binarized OCT images. In this regard, the choroidal vascularity index (CVI) is emerging as a new imaging tool for the measurement and analysis of the choroidal vascular system by quantifying both luminal and stromal choroidal components. Numerous reports have been published so far regarding CVI and its potential applications in healthy eyes as well as in the evaluation and management of several chorioretinal diseases. Current literature suggests that CVI has a lesser variability and is influenced by fewer physiologic factors as compared to choroidal thickness. It can be considered a relatively stable parameter for evaluating the changes in the choroidal vasculature. In this review, the principles and the applications of this advanced imaging modality for studying and understanding the contributing role of choroid in retinal and optic nerve diseases are discussed. Potential advances that may allow the widespread adoption of this tool in the routine clinical practice are also presented.

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Comparing effects of photodynamic therapy in central serous chorioretinopathy: full-dose versus half-dose versus half-dose-half-fluence

Cited by 29 publications

References 24 publications

Choroidal and Retinal Changes After Systemic Adrenaline and Photodynamic Therapy in Non-Human Primates

Choroidal and Retinal Changes After Systemic Adrenaline and Photodynamic Therapy in Non-Human Primates

Prospective evaluation of changes in choroidal vascularity index after half-dose photodynamic therapy versus micropulse laser treatment in chronic central serous chorioretinopathy

Choroidal Vascularity Index: An In-Depth Analysis of This Novel Optical Coherence Tomography Parameter

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