Journal
GRAEFES ARCHIVE FOR CLINICAL AND EXPERIMENTAL OPHTHALMOLOGY
Volume 259, Issue 4, Pages 905-910Publisher
SPRINGER
DOI: 10.1007/s00417-020-04959-3
Keywords
Central serous chorioretinopathy; Foveal atrophy; Photodynamic therapy; Fluorescein angiography
Categories
Funding
- MaculaFonds
- Retina Netherlands
- BlindenPenning
- Landelijke Stichting voor Blinden en Slechtzienden
- Rotterdamse Stichting Blindenbelangen
- Haagse Stichting Blindenhulp
- ZonMw VENI Grant
- Gisela Thier Fellowship of Leiden University
- Oxford NIHR Biomedical Research Centre
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The study evaluated the clinical outcomes after half-dose PDT in cCSC patients with pre-existing fovea-involving atrophy. It found that anatomical changes may occur after treatment, but functional improvements are limited. Early treatment with half-dose PDT before the occurrence of such atrophy is recommended to optimize outcomes.
Purpose To evaluate the clinical outcomes after half-dose photodynamic therapy (PDT) in chronic central serous chorioretinopathy (cCSC) patients with pre-existent fovea-involving atrophy. Methods In this retrospective study, cCSC patients who had a window defect of the retinal pigment epithelium (RPE) on fluorescein angiography (FA), compatible with RPE atrophy, prior to half-dose PDT were included. Results Thirty-four cCSC eyes with typical findings of cCSC on multimodal imaging, and fovea-involving RPE atrophy on FA, were included. At the first visit after PDT (at a median of 1.8 months after half-dose PDT), 20 eyes (59%) had a complete resolution of SRF (p < 0.001), while this was the case in 19 eyes (56%) at final visit (median of 11.3 months after half-dose PDT; p < 0.001). The mean BCVA in Early Treatment of Diabetic Retinopathy Study letters was 71. 2 +/- 15.9 at last visit before PDT, which increased to 74.1 +/- 14.1 at first visit after PDT (p = 0.093, compared with baseline), and changed to 73.0 +/- 19.1 at final visit (p = 0.392, compared with baseline). Both at first visit after PDT and at final visit, a significant decrease in subfoveal choroidal thickness was observed (p = 0.032 and p = 0.004, respectively). Conclusions Half-dose PDT in cCSC patients with pre-existing fovea-involving atrophy may lead to anatomical changes, but not to functional improvements. Ideally, cCSC should be treated with half-dose PDT before the occurrence of such atrophy.
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