Functional Retinal Changes Measured by Microperimetry in Standard-Fluence vs Low-Fluence Photodynamic Therapy in Chronic Central Serous Chorioretinopathy

Reibaldi, Michele; Boscia, Francesco; Avitabile, Teresio; Uva, Maurizio G.; Russo, Andrea; Zagari, Marco; Occhipinti, Francesco; Russo, Vincenzo; Reibaldí, A.; Longo, Antonio

doi:10.1016/j.ajo.2010.12.007

Cited by 50 publications

(45 citation statements)

References 30 publications

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“…The MP-1 microperimeter allows automated functional analysis of the macula, associated with real-time correction of eye movements. Studies with microperimetry in eyes with CSC show significantly lower RS not only at the central but also in the paracentral area of the macula [29][30][31][32]. Furthermore, Ozdemir et al [33] found that eyes with resolved CSC had a statistically significant reduced central RS compared with controls.…”

Section: Discussionmentioning

confidence: 98%

Long-term chorioretinal changes after photodynamic therapy for chronic central serous chorioretinopathy

Vasconcelos

Marques

Santos

et al. 2013

Graefes Arch Clin Exp Ophthalmol

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Purpose To evaluate morphological and functional chorioretinal changes 5 years after standard photodynamic therapy (PDT) for chronic central serous chorioretinopathy (CSC). Methods A retrospective, nonrandomized study, including patients with chronic CSC treated with standard PDT and followed for at least 60 months. All patients underwent a complete ophthalmological examination, and the location and number of treatments were registered. Five or more years after treatment, subfoveal and non-subfoveal treated areas were evaluated with Spectralis optical coherence tomography and microperimetry. Results Seventeen eyes of 15 patients were included, with mean age of 48.3±8.4 years and a mean follow-up of 80.6± 12.4 months (range from 62 to 104 months). All eyes had neurosensory detachment (NSD) at baseline. Treatment was performed under the fovea in 58.8 % and in a non-foveal area in 41.2 % of the eyes. At the final visit all eyes had resolution of the NSD, with a statistical significant reduction in central macular thickness (p=0.005) and preserved neuroretinal thickness (p=0.839). There was a statistical difference between initial and final BCVA (p<0.001) and a mean gain of 8.4±7.8 letters. Subfoveal morphological changes in external limiting membrane (ELM) and in photoreceptor inner and outer segment junction (IS/OS) were correlated with final BCVA (p=0.015 and p=0.014 respectively), but not with the variation of BCVA. There was a statistical correlation between morphological changes in IS/OS line and retinal sensitivity in the central 12°and 2°(p=0.003 and p=0.002 respectively). The morphological changes in the subfoveal layers were not dependent on treatment location (p=0.154, p=0.644, and p=1.0 for ELM, IS/OS line, and retinal pigment epithelium respectively). Subfoveal final mean choroidal thickness was 295.1±68.7 μm, and showed no statistical difference from the normal population (p=0.633). Conclusions Morphological and functional chorioretinal changes, observed 5 or more years after standard PDT for chronic CSC, were not correlated with the location of treatment, neither with the progression of visual acuity or with the location of treatment, and are more likely to be related to the disease itself than with the treatment provided.

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Section: Discussionmentioning

confidence: 98%

Long-term chorioretinal changes after photodynamic therapy for chronic central serous chorioretinopathy

Vasconcelos

Marques

Santos

et al. 2013

Graefes Arch Clin Exp Ophthalmol

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“…Reibaldi et al, [21] evaluated low-fluence PDT (25J/cm 2 ) versus standard fluence (50J/cm 2 ) and found improvement in bestcorrected VA at 12 months in both groups with resorption of SRF in a significant number of eyes. However, these authors also noted significant choriocapillaris nonperfusion in 44% of eyes treated with standard-fluence PDT versus 0% in those treated with reduced-fluence PDT.…”

Section: Resultsmentioning

confidence: 99%

“…However, treatment success is limited by complications, including RPE atrophy and tears, choroidal neovascularization, and ischemia [18]. In an effort to minimize complications, PDT has been used at half the regular dose, fluence, or both [19][20][21][22][23]. This has been shown to reduce SRF doi: 10.7243/2055-2408-1-2 and improve visual acuity (VA) and retinal sensitivity.…”

Section: Introductionmentioning

confidence: 99%

Half-dose and half-fluence photodynamic therapy for central serous chorioretinopathy

Rosenthal¹,

Flaxel²

2014

J Eye Ophthalmol

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Background: Chronic central serous chorioretinopathy presents a treatment challenge. Photodynamic therapy has been used successfully but with side effects; thus, the authors explored half-dose and half-fluence photodynamic therapy as lower-risk alternatives. Methods: Retrospective medical record review of patients with chronic or recurrent central serous chorioretinopathy who received half-dose or half-fluence photodynamic therapy from May 2008 through March 2011 at a tertiary care referral center in Portland, Oregon, USA. The authors recorded demographics, visual acuity, and change in central retinal thickness as measured by optical coherence tomography. Results: Eight patients aged 46 to 80 years (11 eyes) were treated for central serous chorioretinopathy with half-dose or half-fluence photodynamic therapy, or with both of these treatment modalities on different occasions. Visual acuity before treatment ranged from 20/15 to 20/100; after treatment, visual acuity also ranged from 20/15 to 20/100. The authors noted no significant differences between half-dose and half-fluence photodynamic therapy and no serious treatment complications. Conclusions: Half-dose and half fluence photodynamic therapy are safe and effective treatment alternatives for chronic central serous chorioretinopathy.

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“…13,[48][49][50][51][52] Reduced fluence vPDT therapy uses a vPDT laser fluence of 25 J/cm 2 (300 mW/cm 2 for 83 s). 14,15,53,54 There is limited evidence to compare these different vPDT protocols for CSC in the absence of randomised controlled trials. 44,[55][56][57][58] The current approach to management of CSC is largely empirical.…”

Section: Central Serous Chorioretinopathymentioning

confidence: 99%

“…There is limited evidence to determine the optimum vPDT therapy parameters for different chorioretinal conditions. [12][13][14][15] Neovascular age-related macular degeneration vPDT therapy was developed to treat neovascular AMD with subfoveal CNV. Phase I/II clinical studies demonstrated that a single treatment achieved effective CNV closure, but reperfusion typically occurred after 6-12 weeks.…”

Section: Vpdt Treatment Protocolsmentioning

confidence: 99%

Photodynamic therapy: current role in the treatment of chorioretinal conditions

Newman

2016

Eye

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Verteporfin photodynamic therapy (vPDT) is a selective vaso-occlusive treatment that targets choroidal vascular abnormalities. It was initially developed to treat neovascular age-related macular degeneration using the 'standard' vPDT protocol (verteporfin 6 mg/ m 2 , vPDT laser fluence 50 J/cm 2 ). vPDT therapy has subsequently evolved as an important treatment modality for a range of other chorioretinal conditions including choroidal haemangioma, central serous chorioretinopathy, polypoidal choroidal vasculopathy, and peripapillary choroidal neovascularisation. Various 'safety-enhanced' vPDT protocols have been devised to optimise treatment outcomes, typically using reduced dose verteporfin (verteporfin 3 mg/m 2 ) or reduced fluence vPDT (vPDT laser fluence 25 J/cm 2 ). This paper reviews the current role of vPDT therapy in the treatment of chorioretinal conditions.

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Functional Retinal Changes Measured by Microperimetry in Standard-Fluence vs Low-Fluence Photodynamic Therapy in Chronic Central Serous Chorioretinopathy

Cited by 50 publications

References 30 publications

Long-term chorioretinal changes after photodynamic therapy for chronic central serous chorioretinopathy

Long-term chorioretinal changes after photodynamic therapy for chronic central serous chorioretinopathy

Half-dose and half-fluence photodynamic therapy for central serous chorioretinopathy

Photodynamic therapy: current role in the treatment of chorioretinal conditions

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