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

  • Retinal Disorders
  • Published:
Graefe's Archive for Clinical and Experimental Ophthalmology Aims and scope Submit manuscript

Abstract

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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References

  1. Gass JD (1967) Pathogenesis of disciform detachment of the neuroepithelium. Am J Ophthalmol 63(Suppl):1–139

    PubMed  Google Scholar 

  2. Guyer DR, Yannuzzi LA, Slakter JS, Sorenson JA, Ho A, Orlock D (1994) Digital indocyanine green videoangiography of central serous chorioretinopathy. Arch Ophthalmol 112:1057–1562

    Article  PubMed  CAS  Google Scholar 

  3. Yannuzzi LA (2010) Central serous chorioretinopathy: a personal perspective. Am J Ophthalmol 149:361–363

    Article  PubMed  Google Scholar 

  4. Lim JW, Kang SE, Kim YT, Chung SE, Lee SW (2011) Comparative study of patients with central serous chorioretinopathy undergoing focal laser photocoagulation or photodynamic therapy. Br J Ophthalmol 95:514–517

    Article  PubMed  Google Scholar 

  5. Lai TY, Chan WM, Li H, Lai RY, Liu DT, Lam DS (2006) Safety enhanced photodynamic therapy with half dose verteporfin for chronic central serous chorioretinopathy: a short term pilot study. Br J Ophthalmol 90:869–874

    Article  PubMed  CAS  Google Scholar 

  6. Koytak A, Erol K, Coskun E, Asik N, Öztürk H, Özertürk Y (2010) Fluorescein angiography-guided photodynamic therapy with half-dose verteporfin for chronic central serous chorioretinopathy. Retina 30:1698–1703

    Article  PubMed  Google Scholar 

  7. Chan WM, Lai TY, Lai RY, Tang EW, Liu DT, Lam DS (2008) Safety enhanced photodynamic therapy for chronic central serous chorioretinopathy: one-year results of a prospective study. Retina 28:85–93

    Article  PubMed  Google Scholar 

  8. Chan WM, Lai TY, Lai RY, Liu DT, Lam DS (2008) Half-dose verteporfin photodynamic therapy for acute central serous chorioretinopathy: one-year results of a randomized controlled trial. Ophthalmology 115:1756–1765

    Article  PubMed  Google Scholar 

  9. Reibaldi M, Cardascia N, Longo A, Furino C, Avitabile T, Faro S, Sanfilippo M, Russo A, Uva MG, Munno F, Cannemi V, Zagari M, Boscia F (2010) Standard-fluence versus low-fluence photodynamic therapy in chronic central serous chorioretinopathy: a nonrandomized clinical trial. Am J Ophthalmol 149:307–315

    Article  PubMed  Google Scholar 

  10. Shin JY, Woo SJ, Yu HG, Park KH (2011) Comparison of efficacy and safety between half-fluence and full-fluence photodynamic therapy for chronic central serous chorioretinopathy. Retina 31:119–126

    Article  PubMed  CAS  Google Scholar 

  11. Taban M, Boyer DS, Thomas EL, Taban M (2004) Chronic central serous chorioretinopathy: photodynamic therapy. Am J Ophthalmol 137:1073–1080

    Article  PubMed  Google Scholar 

  12. Yannuzzi LA, Slakter JS, Gross NE, Spaide RF, Costa DL, Huang SJ, Klancnik JM Jr, Aizman A (2003) Indocyanine green angiography-guided photodynamic therapy for treatment of chronic central serous chorioretinopathy: a pilot study. Retina 23:288–298

    Article  PubMed  Google Scholar 

  13. Ruiz-Moreno JM, Lugo FL, Armadá F, Silva R, Montero JA, Arevalo JF, Arias L, Gómez-Ulla F (2010) Photodynamic therapy for chronic central serous chorioretinopathy. Acta Ophthalmol 88:371–376

    PubMed  Google Scholar 

  14. Tarantola RM, Law JC, Recchia FM, Sternberg P Jr, Agarwal A (2008) Photodynamic therapy as treatment of chronic idiopathic central serous chorioretinopathy. Lasers Surg Med 40:671–675

    Article  PubMed  Google Scholar 

  15. Cardillo Piccolino F, Eandi CM, Ventre L, Rigault de la Longrais RC, Grignolo FM (2003) Photodynamic therapy for chronic central serous chorioretinopathy. Retina 23:752–763

    Article  PubMed  Google Scholar 

  16. Copete S, Ruiz-Moreno JM, Cava C, Montero JA (2012) Retinal thickness changes following photodynamic therapy in chronic central serous chorioretinopathy. Graefes Arch Clin Exp Ophthalmol 250:803–808

    Article  PubMed  Google Scholar 

  17. Chan WM, Lam DS, Lai TY, Tam BS, Liu DT, Chan CK (2003) Choroidal vascular remodelling in central serous chorioretinopathy after indocyanine green guided photodynamic therapy with verteporfin: a novel treatment at the primary disease level. Br J Ophthalmol 87:1453–1458

    Article  PubMed  Google Scholar 

  18. Colucciello M (2006) Choroidal neovascularization complicating photodynamic therapy for central serous retinopathy. Retina 26:239–242

    Article  PubMed  Google Scholar 

  19. Lai TY, Chan WM, Lam DS (2004) Transient reduction in retinal function revealed by multifocal electroretinogram following photodynamic therapy. Am J Ophthalmol 137:826–833

    Article  PubMed  Google Scholar 

  20. Treatment of Age-Related Macular Degeneration with Photodynamic Therapy (TAP) Study Group (1999) Photodynamic therapy of subfoveal choroidal neovascularization in age-related macular degeneration with verteporfin: one-year results of 2 randomized clinical trials—TAP report. Arch Ophthalmol 117:1329–1345

    Google Scholar 

  21. Margolis R, Spaide RF (2009) A pilot study of enhanced depth imaging optical coherence tomography of the choroid in normal eyes. Am J Ophthalmol 147:811–815

    Article  PubMed  Google Scholar 

  22. Schmidt-Erfurth U, Hasan T, Gragoudas E, Michaud N, Flotte TJ, Birngruber R (1994) Vascular targeting in photodynamic occlusion of subretinal vessels. Ophthalmology 101:1953–1961

    PubMed  CAS  Google Scholar 

  23. Schmidt-Erfurth U, Hasan T (2000) Mechanisms of action of photodynamic therapy with verteporfin for the treatment of age-related macular degeneration. Surv Ophthalmol 45:195–214

    Article  PubMed  CAS  Google Scholar 

  24. Silva R, Ruiz-Moreno JM, Gomez-Ulla F, Montero JA, Gregório T, Cachulo ML, Pires I, Cunha-Vaz JG, Murta JN (2013) Photodynamic therapy for chronic central serous chorioretinopathy: a 4 year follow-up study. Retina 33(2):309–315

    Article  PubMed  CAS  Google Scholar 

  25. Cardillo Piccolino F, Rigault de la Longrais RC, Ravera G, Eandi CM, Ventre L, Abdollahi A, Manea M (2005) The foveal photoreceptor layer and visual acuity loss in central serous chorioretinopathy. Am J Ophthalmol 139:87–99

    Article  Google Scholar 

  26. Moon JW, Yu HG, Kim TW, Kim HC, Chung H (2009) Prognostic factors related to photodynamic therapy for central serous chorioretinopathy. Graefes Arch Clin Exp Ophthalmol 247:1315–1323

    Article  PubMed  CAS  Google Scholar 

  27. Kim YY, Flaxel CJ (2011) Factors influencing the visual acuity of chronic central serous chorioretinopathy. Korean J Ophthalmol 25:90–97

    Article  PubMed  Google Scholar 

  28. Ooto S, Hangai M, Sakamoto A, Tsujikawa A, Yamashiro K, Ojima Y, Yamada Y, Mukai H, Oshima S, Inoue T, Yoshimura N (2010) High-resolution imaging of resolved central serous chorioretinopathy using adaptive optics scanning laser ophthalmoscopy. Ophthalmology 117(9):1800–1809

    Article  PubMed  Google Scholar 

  29. Fujita K, Yuzawa M, Mori R (2011) Retinal sensitivity after photodynamic therapy with half-dose verteporfin for chronic central serous chorioretinopathy: short-term results. Retina 31:772–778

    PubMed  CAS  Google Scholar 

  30. Senturk F, Karacorlu M, Ozdemir H, Karacorlu SA, Uysal O (2011) Microperimetric changes after photodynamic therapy for central serous chorioretinopathy. Am J Ophthalmol 151:303–309

    Article  Google Scholar 

  31. Reibaldi M, Boscia F, Avitabile T, Uva MG, Russo A, Zagari M, Occhipinti F, Russo V, Reibaldi A, Longo A (2011) Functional retinal changes measured by microperimetry in standard-fluence vs low-fluence photodynamic therapy in chronic central serous chorioretinopathy. Am J Ophthalmol 151:953–960

    Article  PubMed  Google Scholar 

  32. Ozdemir H, Senturk F, Karacorlu M, Karacorlu SA, Uysal O (2008) Macular sensitivity in eyes with central serous chorioretinopathy. Eur J Ophthalmol 18:799–804

    PubMed  CAS  Google Scholar 

  33. Ozdemir H, Karacorlu SA, Senturk F, Karacorlu M, Uysal O (2008) Assessment of macular function by microperimetry in unilateral resolved central serous chorioretinopathy. Eye (Lond) 22:204–208

    Article  CAS  Google Scholar 

  34. Ehrlich R, Mawer NP, Mody CH, Brand CS, Squirrell D (2012) Visual function following photodynamic therapy for central serous chorioretinopathy: a comparison of automated macular microperimetry versus best-corrected visual acuity. Clin Experiment Ophthalmol 40:e32–e39

    Article  PubMed  Google Scholar 

  35. Fujita K, Shinoda K, Imamura Y, Matsumoto CS, Mizutani Y, Mizota A, Yuzawa M (2012) Correlation of integrity of cone outer segment tips line with retinal sensitivity after half-dose photodynamic therapy for chronic central serous chorioretinopathy. Am J Ophthalmol 154(3):579–585

    Article  PubMed  Google Scholar 

  36. Ojima Y, Tsujikawa A, Hangai M, Nakanishi H, Inoue R, Sakamoto A, Yoshimura N (2008) Retinal sensitivity measured with the micro perimeter 1 after resolution of central serous chorioretinopathy. Am J Ophthalmol 146:77–84

    Article  PubMed  Google Scholar 

  37. Spaide RF, Koizumi H, Pozzoni MC (2008) Enhanced depth imaging spectral-domain optical coherence tomography. Am J Ophthalmol 146:496–500

    Article  Google Scholar 

  38. Imamura Y, Fujiwara T, Margolis R, Spaide RF (2009) Enhanced depth imaging optical coherence tomography of the choroid in central serous chorioretinopathy. Retina 29:1469–1473

    Article  Google Scholar 

  39. Maruko I, Iida T, Sugano Y, Ojima A, Sekiryu T (2011) Subfoveal choroidal thickness in fellow eyes of patients with central serous chorioretinopathy. Retina 31:1603–1608

    Article  PubMed  Google Scholar 

  40. Kim YT, Kang SW, Bai KH (2011) Choroidal thickness in both eyes of patients with unilaterally active central serous chorioretinopathy. Eye (Lond) 25:1635–1640

    Article  CAS  Google Scholar 

  41. Maruko I, Iida T, Sugano Y, Ojima A, Ogasawara M, Spaide RF (2010) Subfoveal choroidal thickness after treatment of central serous chorioretinopathy. Ophthalmology 117:1792–1799

    Article  PubMed  Google Scholar 

  42. Maruko I, Iida T, Sugano Y, Furuta M, Sekiryu T (2011) One-year choroidal thickness results after photodynamic therapy for central serous chorioretinopathy. Retina 31:1921–1927

    Article  PubMed  Google Scholar 

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Correspondence to Helena Vasconcelos.

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Vasconcelos, H., Marques, I., Santos, A.R. et al. Long-term chorioretinal changes after photodynamic therapy for chronic central serous chorioretinopathy. Graefes Arch Clin Exp Ophthalmol 251, 1697–1705 (2013). https://doi.org/10.1007/s00417-013-2270-2

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  • DOI: https://doi.org/10.1007/s00417-013-2270-2

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