Skip to main content
Published Online:https://doi.org/10.3928/23258160-20181212-04Cited by:5

Abstract

BACKGROUND AND OBJECTIVES:

To report the acute and long-term choroidal findings in patients with chronic central serous chorioretinopathy (CCSC) undergoing half-fluence photodynamic therapy (PDT).

PATIENTS AND METHODS:

This is a prospective, consecutive, interventional, noncomparative case series at a tertiary referral vitreoretinal practice. Twenty-one eyes from 21 patients are included.

RESULTS:

Among 21 eyes, all had improved vision following PDT during a mean of 5.2 months ± 4.8 months of follow-up. The incidence of choroidal neovascular membranes was 19.0% (four in 21), with only one of these eyes (4.8%) requiring intravitreal anti-vascular endothelial growth factor injections. Changes in the choriocapillaris were noted in 28.6% (six of 21) eyes following PDT. Eighteen patients (85.7%) demonstrated striking regions of dilated choroidal vessels closely corresponding to regions of outer retinal changes and subretinal fluid. Twenty patients (95.2%) experienced resolution of subretinal fluid within 3 months of receiving PDT.

CONCLUSION:

Optical coherence tomography angiography may provide new insight into the pathogenesis of CCSC, namely in identifying a correlation between structures of the deep choroid and changes in the retinal pigment epithelium and neurosensory retina.

[Ophthalmic Surg Lasers Imaging Retina. 2019;50:25–32.]

  • 1.Liegl R, Ulbig MW. Central serous chorioretinopathy. Ophthalmologica. 2014; 232(2):65–76.10.1159/000360014

    Crossref MedlineGoogle Scholar
  • 2.Nicholson B, Noble J, Forooghian F, Meyerle C. Central serous chorioretinopathy: Update on pathophysiology and treatment. Surv Ophthalmol. 2013; 58(2):103–126.10.1016/j.survophthal.2012.07.004

    Crossref MedlineGoogle Scholar
  • 3.Casella AM, Berbel RF, Bressanim GL, Malaguido MR, Cardillo JA. Helicobacter pylori as a potential target for the treatment of central serous chorioretinopathy. Clinics (Sao Paolo). 2012; 67(9):1047–1052.10.6061/clinics/2012(09)11

    Crossref MedlineGoogle Scholar
  • 4.Eom Y, Oh J, Kim SW, Huh K. Systemic factors associated with central serous chorioretinopathy in Koreans. Korean J Ophthalmol. 2012; 26(4):260–264.10.3341/kjo.2012.26.4.260

    Crossref MedlineGoogle Scholar
  • 5.Errera MH, Kohly RP, da Cruz L. Pregnancy-associated retinal diseases and their management. Surv Ophthalmol. 2013; 58(2):127–142.10.1016/j.survophthal.2012.08.001

    Crossref MedlineGoogle Scholar
  • 6.Fawzi AA, Holland GN, Kreiger AE, Heckenlively JR, Arroyo JG, Cunningham ETCentral serous chorioretinopathy after solid organ transplantation. Ophthalmology. 2006; 113(5):805–813.e5.10.1016/j.ophtha.2006.01.031

    Crossref MedlineGoogle Scholar
  • 7.Garg SP, Dada T, Talwar D, Biswas NR. Endogenous cortisol profile in patients with central serous chorioretinopathy. Br J Ophthalmol. 1997; 81(11):962–964.10.1136/bjo.81.11.962

    Crossref MedlineGoogle Scholar
  • 8.Spaide RF, Campeas L, Haas A, et al.Central serous chorioretinopathy in younger and older adults. Ophthalmology. 1996; 103(12):2070–2079; discussion 2079–2080.10.1016/S0161-6420(96)30386-2

    Crossref MedlineGoogle Scholar
  • 9.Yannuzzi LA. Type-A behavior and central serous chorioretinopathy. Retina. 1987; 7(2):111–131.10.1097/00006982-198700720-00009

    Crossref MedlineGoogle Scholar
  • 10.Bujarborua D, Nagpal PN, Deka M. Smokestack leak in central serous chorioretinopathy. Graefes Arch Clin Exp Ophthalmol. 2010; 248(3):339–351.10.1007/s00417-009-1212-5

    Crossref MedlineGoogle Scholar
  • 11.Gass JD. Pathogenesis of disciform detachment of the neuroepithelium. Am J Ophthalmol. 1967; 63(3):Suppl:1–139.

    Google Scholar
  • 12.Maumenee AE. Macular diseases: Clinical manifestations. Trans Am Acad Ophthalmol Otolaryngol. 1965; 69:605–613.

    MedlineGoogle Scholar
  • 13.Giovannini A, Scassellati-Sforzolini B, D'Altobrando E, Mariotti C, Rutili T, Tittarelli R. Choroidal findings in the course of idiopathic serous pigment epithelium detachment detected by indocyanine green videoangiography. Retina. 1997; 17(4):286–293.10.1097/00006982-199717040-00002

    Crossref MedlineGoogle Scholar
  • 14.Piccolino FC, Borgia L. Central serous chorioretinopathy and indocyanine green angiography. Retina. 1994; 14(3):231–42.10.1097/00006982-199414030-00008

    Crossref MedlineGoogle Scholar
  • 15.Prünte C, Flammer J. Choroidal capillary and venous congestion in central serous chorioretinopathy. Am J Ophthalmol. 1996; 121(1):26–34.10.1016/S0002-9394(14)70531-8

    Crossref MedlineGoogle Scholar
  • 16.Yoshioka H, Katsume Y. Experimental central serous chorioretinopathy. III: Uultrastructural findings. Jpn J Ophthalmol. 1982; 26(4):397–409.

    MedlineGoogle Scholar
  • 17.Jampol LM, Weinreb R, Yannuzzi L. Involvement of corticosteroids and catecholamines in the pathogenesis of central serous chorioretinopathy: A rationale for new treatment strategies. Ophthalmology. 2002; 109(10):1765–1766.10.1016/S0161-6420(02)01303-9

    Crossref MedlineGoogle Scholar
  • 18.Marmor MF. New hypotheses on the pathogenesis and treatment of serous retinal detachment. Graefes Arch Clin Exp Ophthalmol. 1988; 226(6):548–552.10.1007/BF02169203

    Crossref MedlineGoogle Scholar
  • 19.Spitznas M. Pathogenesis of central serous retinopathy: A new working hypothesis. Graefes Arch Clin Exp Ophthalmol. 1986; 224(4):321–324.10.1007/BF02150023

    Crossref MedlineGoogle Scholar
  • 20.Tewari HK, Gadia R, Kumar D, Venkatesh P, Garg SP. Sympathetic-parasympathetic activity and reactivity in central serous chorioretinopathy: A case-control study. Invest Ophthalmol Vis Sci. 2006; 47(8):3474–3478.10.1167/iovs.05-1246

    Crossref MedlineGoogle Scholar
  • 21.Lim JI, Glassman AR, Aiello LP, et al.Collaborative retrospective macula society study of photodynamic therapy for chronic central serous chorioretinopathy. Ophthalmology. 2014; 121(5):1073–1078.10.1016/j.ophtha.2013.11.040

    Crossref MedlineGoogle Scholar
  • 22.Chan WM, Lam DS, Lai TY, Tam BS, Liu DT, Chan CK. 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. 2003; 87(12):1453–1458.10.1136/bjo.87.12.1453

    Crossref MedlineGoogle Scholar
  • 23.Ruiz-Moreno JM, Lugo FL, Armada F, et al.Photodynamic therapy for chronic central serous chorioretinopathy. Acta Ophthalmol. 2010; 88(3):371–376.10.1111/j.1755-3768.2008.01408.x

    Crossref MedlineGoogle Scholar
  • 24.Loo RH, Scott IU, Flynn HW, et al.Factors associated with reduced visual acuity during long-term follow-up of patients with idiopathic central serous chorioretinopathy. Retina. 2002; 22(1):19–24.10.1097/00006982-200202000-00004

    Crossref MedlineGoogle Scholar
  • 25.Song IS, Shin YU, Lee BR. Time-periodic characteristics in the morphology of idiopathic central serous chorioretinopathy evaluated by volume scan using spectral-domain optical coherence tomography. Am J Ophthalmol. 2012; 154(2):366–375.e4.10.1016/j.ajo.2012.02.031

    Crossref MedlineGoogle Scholar
  • 26.Gomolin JE. Choroidal neovascularization and central serous chorioretinopathy. Can J Ophthalmol. 1989; 24(1):20–23.

    MedlineGoogle Scholar
  • 27.Bonini Filho MA, de Carlo TE, Ferrara D, et al.Association of choroidal neovascularization and central serous chorioretinopathy with optical coherence tomography angiography. JAMA Ophthalmology. 2015; 133(8):899–906.10.1001/jamaophthalmol.2015.1320

    Crossref MedlineGoogle Scholar
  • 28.Costanzo E, Cohen SY, Miere A, et al.Optical coherence tomography angiography in central serous chorioretinopathy. J Ophthalmol. 2015; 2015:134783.10.1155/2015/134783

    Crossref MedlineGoogle Scholar
  • 29.Bousquet E, Bonnin S, Mrejen S, Krivosic V, Tadayoni R, Gaudric A. Optical coherence tomography angiography of flat irregular pigment epithelium detachment in chronic central serous chorioretinopathy. Retina. 2018; 38(3):629–638.10.1097/IAE.0000000000001580

    Crossref MedlineGoogle Scholar
  • 30.de Carlo TE, Rosenblatt A, Goldstein M, Baumal CR, Loewenstein A, Duker JS. Vascularization of irregular retinal pigment epithelial detachments in chronic central serous chorioretinopathy evaluated with OCT angiography. Ophthalmic Surg Lasers Imaging Retina. 2016; 47(2):128–133.10.3928/23258160-20160126-05

    LinkGoogle Scholar
  • 31.Teussink MM, Breukink MB, van Grinsven MJ, et al.OCT angiography compared to fluorescein and indocyanine green angiography in chronic central serous chorioretinopathy. Invest Ophthalmol Vis Sci. 2015; 56(9):5229–5237.10.1167/iovs.15-17140

    Crossref MedlineGoogle Scholar
  • 32.Slakter JS, Yannuzzi LA, Guyer DR, Sorenson JA, Orlock DA. Indocyanine-green angiography. Curr Opin Ophthalmol. 1995; 6(3):25–32.10.1097/00055735-199506000-00005

    Crossref MedlineGoogle Scholar
  • 33.Uyama M, Matsunaga H, Matsubara T, Fukushima I, Takahashi K, Nishimura T. Indocyanine green angiography and pathophysiology of multifocal posterior pigment epitheliopathy. Retina. 1999; 19(1):12–21.10.1097/00006982-199901000-00003

    Crossref MedlineGoogle Scholar
  • 34.Xu Y, Su Y, Li L, Qi H, Zheng H, Chen C. Effect of photodynamic therapy on optical coherence tomography angiography in eyes with chronic central serous chorioretinopathy. Ophthalmologica. 2017; 237(3):167–172.10.1159/000456676

    Crossref MedlineGoogle Scholar
  • 35.Chen FK, Viljoen RD, Bukowska DM. Classification of image artefacts in optical coherence tomography angiography of the choroid in macular diseases. Clin Exp Ophthalmol. 2016; 44(5):388–399.10.1111/ceo.12683

    Crossref MedlineGoogle Scholar
  • 36.Dansingani KK, Balaratnasingam C, Klufas MA, Sarraf D, Freund KB. Optical coherence tomography angiography of shallow irregular pigment epithelial detachments in pachychoroid spectrum disease. Am J Ophthalmol. 2015; 160(6):1243–1254.e2.10.1016/j.ajo.2015.08.028

    Crossref MedlineGoogle Scholar
  • 37.Maruko I, Iida T, Sugano Y, Furuta M, Sekiryu T. One-year choroidal thickness results after photodynamic therapy for central serous chorioretinopathy. Retina. 2011; 31(9):1921–1927.10.1097/IAE.0b013e31822bf6b1

    Crossref MedlineGoogle Scholar
  • 38.Maruko I, Iida T, Sugano Y, Ojima A, Ogasawara M, Spaide RF. Subfoveal choroidal thickness after treatment of central serous chorioretinopathy. Ophthalmology. 2010; 117(9):1792–1799.10.1016/j.ophtha.2010.01.023

    Crossref MedlineGoogle Scholar
  • 39.Dansingani KK, Balaratnasingam C, Naysan J, Freund KB. En face imaging of pachychoroid spectrum disorders with swept-source optical coherence tomography. Retina. 2016; 36:499–516.10.1097/IAE.0000000000000742

    Crossref MedlineGoogle Scholar
  • 40.Lee WK, Baek J, Dansingani KK, Lee JH, Freund KB. Choroidal morphology in eyes with polypoidal choroidal vasculopathy and normal or subnormal subfoveal choroidal thickness. Retina. 2016; 36Suppl 1:S73–S82.10.1097/IAE.0000000000001346

    Crossref MedlineGoogle Scholar
  • 41.Lee JH, Lee WK. One-year results of adjunctive photodynamic therapy for type 1 neovascularization associated with thickened choroid. Retina. 2016; 36(5):889–895.10.1097/IAE.0000000000000809

    Crossref MedlineGoogle Scholar
  • 42.Warrow DJ, Hoang QV, Freund KB. Pachychoroid pigment epitheliopathy. Retina. 2013; 33(8):1659–1672.10.1097/IAE.0b013e3182953df4

    Crossref MedlineGoogle Scholar

We use cookies on this site to enhance your user experience. For a complete overview of all the cookies used, please see our privacy policy.

×