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Photodynamic therapy for chronic central serous chorioretinopathy
Authors:José M. Ruiz‐Moreno  Francisco L. Lugo  Felix Armadá  Rufino Silva  Javier A. Montero  J. Fernando Arevalo  Luis Arias  Francisco Gómez‐Ulla
Affiliation:1. Department of Ophthalmology, Albacete Medical School, Castilla La Mancha University, Albacete, Spain;2. Alicante Institute of Ophthalmology, VISSUM, Vitreo‐Retinal Unit, Alicante, Spain;3. Ophthalmology Department, La Paz University Hospital, Madrid, Spain;4. Ophthalmology Department, University of Coimbra Hospital, Coimbra, Portugal;5. Ophthalmology Department, Pio del Rio Hortega University Hospital, Valladolid, Spain;6. Central Caracas Ophthalmic Clinic, Caracas, Venezuela;7. Department of Ophthalmology, Bellvitge University Hospital, Barcelona, Spain;8. Ophthalmological Technical Institute, Santiago University, Santiago de Compostela, Spain
Abstract:Purpose: This study aimed to evaluate the efficacy of photodynamic therapy (PDT) in treating chronic central serous chorioretinopathy (CSC). Methods: We describe a non‐randomized, multicentre, interventional case series. A total of 82 eyes of 72 patients with chronic CSC were treated by conventional PDT. LogMAR best corrected visual acuity (BCVA) (ETDRS charts) and central foveal thickness (CFT) measured by optical coherence tomography before and after PDT, number of PDT treatments and complications were used as outcome indicators. Results: Mean follow‐up was 12 ± 10 months and mean age was 46 ± 10 years. Mean logMAR BCVA changed from 0.53 (standard deviation [SD] 0.43) before PDT to 0.38 (SD 0.41) at 3 months and 0.48 (SD 0.50) at 6 months (p < 0.0001 and p = 0.007, respectively, Student’s t‐test for paired data). Mean BCVA at the end of follow‐up was 0.37 (SD 0.45; p < 0.0001 from baseline). Macular detachment was resolved and subretinal fluid (SRF) disappeared in all cases. Central foveal thickness decreased from 325 μm (SD 95), to 229 μm (SD 70) at 1 month after PDT, 206 μm (SD 68) at 3 months, and 202 μm (SD 76) at 6 months (all p < 0.0001, Student’s t‐test for paired data). No cases developed severe visual loss or complications derived from PDT. Reactive retinal pigment epithelium hypertrophy appeared in nine cases after PDT. Conclusions: Photodynamic therapy with verteporfin may be useful in chronic CSC for improving BCVA and reducing SRF and CFT. Randomized studies with longer follow‐up are needed to assess the real role of this treatment in chronic CSC.
Keywords:central serous chorioretinopathy  optical coherence tomography  photodynamic therapy  retinal pigment epithelium
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