Clinical Characteristics of Chronic Central Serous Chorioretinopathy Patients with Insufficient Response to Reduced-settings Photodynamic Therapy

Overview

Journal Graefes Arch Clin Exp Ophthalmol

Specialty Ophthalmology

Date 2018 May 8

PMID 29732468

Citations 19

Authors

Thomas J van Rijssen

Elon H C van Dijk

Greet Dijkman

Camiel J F Boon

Affiliations

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Abstract

Purpose: To identify characteristics of Caucasian chronic central serous chorioretinopathy (cCSC) patients without a complete resolution of subretinal fluid (SRF) after reduced-settings photodynamic therapy (PDT), or with a recurrence of SRF after PDT.

Methods: Chronic CSC patients treated with reduced-settings PDT were divided into a successful PDT group and unsuccessful PDT group. Patients in the successful PDT group did not have any subretinal fluid (SRF) during follow-up after PDT, whereas the unsuccessful PDT group was categorized based on either persistence or recurrence of SRF after PDT treatment. Data on age, sex, best-corrected visual acuity (BCVA), PDT spot size, characteristics on fluorescein angiography (FA), indocyanine green angiography (ICGA), and optical coherence tomography (OCT) were obtained.

Results: Twenty-six patients in the successful PDT group (20 males, 6 females) had a mean age of 51 years (range, 25-78). In the unsuccessful PDT group, 20 males with a mean age of 60 years (range, 34-78) were included. At last visit before PDT, age, percentage of males, and percentage of patients with diffuse leakage > 1 optic disc diameter on FA were higher in the unsuccessful PDT group (p = 0.010, p = 0.029, and p = 0.008, respectively). At last visit before PDT, BCVA and the percentage of patients with intense hyperfluorescence on ICGA were lower in the unsuccessful group (p = 0.017 and p = 0.004, respectively). Patients with intense hyperfluorescence on ICGA were more likely (95% CI 1.3-333 times) to have a successful outcome (p = 0.045). A decrease in SFCT at final visit was observed in both groups (- 111 μm and p = 0.013, and - 141 μm and p = 0.007, respectively). BCVA only improved at final visit in the successful PDT group (5 Early Treatment of Diabetic Retinopathy Study letters, p < 0.001).

Conclusions: Chronic CSC patients with recurrent or persistent SRF after PDT are characterized by a higher percentage of males, more patients with diffuse leakage on FA, more patients without intense hyperfluorescence on ICGA, higher age, and lower pre-PDT and long-term BCVA than in the successful PDT group. A reduction in SFCT after PDT does not necessarily lead to complete resolution of SRF, while a resolution of SRF appears to be required to lead to a significant BCVA improvement in cCSC.

Citing Articles

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Two-year outcome of half-time photodynamic therapy for chronic central serous chorioretinopathy with and without choroidal neovascularization.

Kamimura A, Miki A, Kishi M, Okuda M, Hayashida-Hirano M, Sakamoto M PLoS One. 2023; 18(5):e0284979.

PMID: 37130134 PMC: 10153719. DOI: 10.1371/journal.pone.0284979.

References

Schlotzer-Schrehardt U, Viestenz A, Naumann G, Laqua H, Michels S, Schmidt-Erfurth U . Dose-related structural effects of photodynamic therapy on choroidal and retinal structures of human eyes. Graefes Arch Clin Exp Ophthalmol. 2002; 240(9):748-57. DOI: 10.1007/s00417-002-0517-4. View

Cheng C, Chang C, Peng C . COMPARISON OF PHOTODYNAMIC THERAPY USING HALF-DOSE OF VERTEPORFIN OR HALF-FLUENCE OF LASER LIGHT FOR THE TREATMENT OF CHRONIC CENTRAL SEROUS CHORIORETINOPATHY. Retina. 2016; 37(2):325-333. DOI: 10.1097/IAE.0000000000001138. View

Cardillo Piccolino F, Rigault de la Longrais R, Ravera G, Eandi C, Ventre L, Abdollahi A . The foveal photoreceptor layer and visual acuity loss in central serous chorioretinopathy. Am J Ophthalmol. 2005; 139(1):87-99. DOI: 10.1016/j.ajo.2004.08.037. View

Liu H, Yang C, Yang C, Ho T, Lin C, Hsieh Y . Half-dose Versus Half-time Photodynamic Therapy for Central Serous Chorioretinopathy. Am J Ophthalmol. 2016; 167:57-64. DOI: 10.1016/j.ajo.2016.04.001. View

Breukink M, Dingemans A, den Hollander A, Keunen J, MacLaren R, Fauser S . Chronic central serous chorioretinopathy: long-term follow-up and vision-related quality of life. Clin Ophthalmol. 2017; 11:39-46. PMC: 5189979. DOI: 10.2147/OPTH.S115685. View

Inoue R, Sawa M, Tsujikawa M, Gomi F . Association between the efficacy of photodynamic therapy and indocyanine green angiography findings for central serous chorioretinopathy. Am J Ophthalmol. 2010; 149(3):441-6.e1-2. DOI: 10.1016/j.ajo.2009.10.011. View

Haga F, Maruko R, Sato C, Kataoka K, Ito Y, Terasaki H . Long-term prognostic factors of chronic central serous chorioretinopathy after half-dose photodynamic therapy: A 3-year follow-up study. PLoS One. 2017; 12(7):e0181479. PMC: 5524407. DOI: 10.1371/journal.pone.0181479. View

Daruich A, Matet A, Marchionno L, De Azevedo J, Ambresin A, Mantel I . ACUTE CENTRAL SEROUS CHORIORETINOPATHY: Factors Influencing Episode Duration. Retina. 2017; 37(10):1905-1915. PMC: 5642321. DOI: 10.1097/IAE.0000000000001443. View

Wang M, Sander B, Larsen M . Retinal atrophy in idiopathic central serous chorioretinopathy. Am J Ophthalmol. 2002; 133(6):787-93. DOI: 10.1016/s0002-9394(02)01438-1. View

10.

Teussink M, Breukink M, van Grinsven M, Hoyng C, Klevering B, Boon C . OCT Angiography Compared to Fluorescein and Indocyanine Green Angiography in Chronic Central Serous Chorioretinopathy. Invest Ophthalmol Vis Sci. 2015; 56(9):5229-37. DOI: 10.1167/iovs.15-17140. View

11.

Haimovici R, Koh S, Gagnon D, Lehrfeld T, Wellik S . Risk factors for central serous chorioretinopathy: a case-control study. Ophthalmology. 2004; 111(2):244-9. DOI: 10.1016/j.ophtha.2003.09.024. View

12.

Chan S, Wang Q, Wei W, Jonas J . OPTICAL COHERENCE TOMOGRAPHIC ANGIOGRAPHY IN CENTRAL SEROUS CHORIORETINOPATHY. Retina. 2016; 36(11):2051-2058. DOI: 10.1097/IAE.0000000000001064. View

13.

Matet A, Daruich A, Zola M, Behar-Cohen F . RISK FACTORS FOR RECURRENCES OF CENTRAL SEROUS CHORIORETINOPATHY. Retina. 2017; 38(7):1403-1414. DOI: 10.1097/IAE.0000000000001729. View

14.

Chen G, Tzekov R, Li W, Jiang F, Mao S, Tong Y . Subfoveal Choroidal Thickness in Central Serous Chorioretinopathy: A Meta-Analysis. PLoS One. 2017; 12(1):e0169152. PMC: 5226680. DOI: 10.1371/journal.pone.0169152. View

15.

Nicolo M, Zoli D, Musolino M, Traverso C . Association between the efficacy of half-dose photodynamic therapy with indocyanine green angiography and optical coherence tomography findings in the treatment of central serous chorioretinopathy. Am J Ophthalmol. 2011; 153(3):474-480.e1. DOI: 10.1016/j.ajo.2011.08.015. View

16.

Fujita K, Imamura Y, Shinoda K, Matsumoto C, Mizutani Y, Hashizume K . One-year outcomes with half-dose verteporfin photodynamic therapy for chronic central serous chorioretinopathy. Ophthalmology. 2014; 122(3):555-61. DOI: 10.1016/j.ophtha.2014.09.034. View

17.

Nicholson B, Noble J, Forooghian F, Meyerle C . Central serous chorioretinopathy: update on pathophysiology and treatment. Surv Ophthalmol. 2013; 58(2):103-26. PMC: 3574296. DOI: 10.1016/j.survophthal.2012.07.004. View

18.

Lin J, Tsubota K, Apte R . A glimpse at the aging eye. NPJ Aging Mech Dis. 2017; 2:16003. PMC: 5515005. DOI: 10.1038/npjamd.2016.3. View

19.

Breukink M, Mohr J, Ossewaarde-van Norel A, den Hollander A, Keunen J, Hoyng C . Half-dose photodynamic therapy followed by diode micropulse laser therapy as treatment for chronic central serous chorioretinopathy: evaluation of a prospective treatment protocol. Acta Ophthalmol. 2015; 94(2):187-97. DOI: 10.1111/aos.12938. View

20.

Lai F, Ng D, Bakthavatsalam M, Chan V, Young A, Luk F . A Multicenter Study on the Long-term Outcomes of Half-dose Photodynamic Therapy in Chronic Central Serous Chorioretinopathy. Am J Ophthalmol. 2016; 170:91-99. DOI: 10.1016/j.ajo.2016.07.026. View