Effects of Half-Dose Photodynamic Therapy on Chronic Central Serous Chorioretinopathy With or Without Macular Neovascularization Assessed Using Optical Coherence Tomography Angiography

Abstract

Purpose: To assess the effects of half-dose photodynamic therapy on subretinal fluid and macular neovascularization (MNV) using optical coherence tomography angiography in patients with chronic central serous chorioretinopathy. Methods: Clinical information on 168 patients (168 eyes) with chronic central serous chorioretinopathy obtained before and 6 months after treatment with half-dose photodynamic therapy was retrospectively analyzed. Patients were categorized into a success (145 eyes) or failure (23 eyes) group based on the absence or presence of subretinal fluid, respectively, and clinical data were compared between them. Macular neovascularization was studied in 147 cases with available optical coherence tomography angiography images. P < 0.05 indicated statistical significance. Results: The success group showed a younger patient age, better posttreatment best-corrected visual acuity, and thicker pretreatment central choroidal thickness (all, P < 0.047) than did the failure group. Regarding MNV analysis, nine, eight, and 130 eyes had definite, possible, and no MNV, respectively, at baseline; among them, 100.0%, 75.0%, and 2.3%, respectively, had MNV at 6 months posttreatment. Patients with definite MNV at baseline were less likely to show successful subretinal fluid resolution. Conclusion: Although half-dose photodynamic therapy is generally effective for the treatment of chronic central serous chorioretinopathy, coexisting MNV may compromise the outcome; thus, optical coherence tomography angiography–based assessment of chronic central serous chorioretinopathy is important.

Laser Treatment of Central Serous Chorioretinopathy – An Update

“…Interestingly, despite overall thickness reduction, the choroidal vascular index is not affected by the procedure. Good responders to PDT have higher choroidal thickness compared to nonresponders [69,97,98]. This finding is also reflected in a study by Arrigo et al, which differentiate CSCR forms into RPE and choroidal subtypes [99].…”

“…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.…”

Long-Term Prognosis of Patients with Polypoidal Choroidal Vasculopathy Treated with Photodynamic Therapy

“…The spectrum of pachychoroid disease includes central serous chorioretinopathy (CSC), pachychoroid pigment epitheliopathy, and pachychoroid neovasculopathy, which also includes PCV [40]. In CSC, PDT is also considered effective, with some reports focusing on the choroidal thickness before and after treatment [41][42][43]. In the present study, the choroidal thickness was not included in the evaluation because it was difficult to measure the choroidal thickness from OCT images as there were many cases before the measurement of choroidal thickness became common.…”