Clinical Science
Long-Term Efficacy and Safety of Photodynamic Therapy in Patients With Chronic Central Serous Chorioretinopathy
Abstract
BACKGROUND AND OBJECTIVE:
To investigate the long-term results of photodynamic therapy (PDT) in chronic central serous chorioretinopathy (CSCR).
PATIENTS AND METHODS:
The authors reviewed patients with chronic CSCR treated with verteporfin PDT in their hospital and followed up for 36 months or longer.
RESULTS:
Among 94 eyes, 76 eyes underwent half-fluence PDT (80.9%), 12 eyes (12.8%) underwent half-dose PDT, and six eyes (6.4%) underwent standard PDT. Mean follow-up duration was 58.1 months± 20.3 months. Mean best-corrected visual acuity improved by 0.15 ± 0.31 logMAR. Seventy-two eyes (77%) had resolution of subretinal fluid 1 month after treatment. Nine eyes (9.6%) showed nonresponse, and 23 (24.5%) showed recurrence. Older age (P = .009) and smaller macular thickness reduction post-PDT (P = .017) were associated with nonresponse. Male sex (P = .021), bilateral CSCR (P = .008), and smaller choroidal thickness reduction (P = .024) were associated with recurrence. Retreatment using PDT resulted in a 90% success rate.
CONCLUSIONS:
Verteporfin PDT for chronic CSCR conferred good visual outcomes, as well as good safety results up to mean 5 years. Although the disease recurred in about one-fifth of the eyes, additional PDT conferred a good response rate.
[Ophthalmic Surg Lasers Imaging Retina. 2019;50:760–770.]
- 1.Yannuzzi LA, Slakter JS, Gross NE, Indocyanine green angiography-guided photodynamic therapy for treatment of chronic central serous chorioretinopathy: a pilot study. 2003. Retina. 2012; 32(suppl 1):288–298. https://doi.org/10.1097/IAE.0b013e31823f99a9 PMID:
10.1097/IAE.0b013e31823f99a9 22451952 Crossref Medline, Google Scholar - 2.Cidad P, González E, Asencio M, García J. Structural and Functional Outcomes in Chronic Central Serous Chorioretinopathy Treated with Photodynamic Therapy. Korean J Ophthalmol. 2015; 29(5):331–335. https://doi.org/10.3341/kjo.2015.29.5.331 PMID:
10.3341/kjo.2015.29.5.331 26457039 Crossref Medline, Google Scholar - 3.Salehi M, Wenick AS, Law HA, Evans JR, Gehlbach P. Interventions for central serous chorioretinopathy: a network meta-analysis. Cochrane Database Syst Rev. 2015;(12):CD011841. https://doi.org/10.1002/14651858.CD011841 PMID:
26691378 Medline, Google Scholar - 4.Karakus SH, Basarir B, Pinarci EY, Kirandi EU, Demirok A. Long-term results of half-dose photodynamic therapy for chronic central serous chorioretinopathy with contrast sensitivity changes. Eye (Lond). 2013; 27(5):612–620. https://doi.org/10.1038/eye.2013.24 PMID:
10.1038/eye.2013.24 Crossref Medline, Google Scholar - 5.Ma J, Meng N, Xu X, Zhou F, Qu Y. System review and meta-analysis on photodynamic therapy in central serous chorioretinopathy. Acta Ophthalmol. 2014; 92(8):e594–e601. https://doi.org/10.1111/aos.12482 PMID:
10.1111/aos.12482 25042260 Crossref Medline, Google Scholar - 6.Nicolò M, Zoli D, Musolino M, Traverso CE. 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. 2012; 153(3):474–480.e1. https://doi.org/10.1016/j.ajo.2011.08.015 PMID:
10.1016/j.ajo.2011.08.015 Crossref Medline, Google Scholar - 7.Shin JY, Woo SJ, Yu HG, Park KH. Comparison of efficacy and safety between half-fluence and full-fluence photodynamic therapy for chronic central serous chorioretinopathy. Retina. 2011; 31(1):119–126. https://doi.org/10.1097/IAE.0b013e3181e378f2 PMID:
10.1097/IAE.0b013e3181e378f2 Crossref Medline, Google Scholar - 8.Reibaldi M, Cardascia N, Longo A, Standard-fluence versus low-fluence photodynamic therapy in chronic central serous chorioretinopathy: a nonrandomized clinical trial. Am J Ophthalmol. 2010; 149(2):307–315.e2. https://doi.org/10.1016/j.ajo.2009.08.026 PMID:
10.1016/j.ajo.2009.08.026 Crossref Medline, Google Scholar - 9.Lai FH, Ng DS, Bakthavatsalam M, 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. https://doi.org/10.1016/j.ajo.2016.07.026 PMID:
10.1016/j.ajo.2016.07.026 27519561 Crossref Medline, Google Scholar - 10.Kim YK, Ryoo NK, Woo SJ, Park KH. Choroidal thickness changes after photodynamic therapy and recurrence of chronic central serous chorioretinopathy. Am J Ophthalmol. 2015; 160(1):72–84. e1. https://doi.org/10.1016/j.ajo.2015.04.011 PMID:
10.1016/j.ajo.2015.04.011 25887629 Crossref Medline, Google Scholar - 11.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. https://doi.org/10.1371/journal.pone.0181479 PMID:
10.1371/journal.pone.0181479 28742138 Crossref Medline, Google Scholar - 12.Ferrara D, Silver RE, Louzada RN, Novais EA, Collins GK, Seddon JM. Optical Coherence Tomography Features Preceding the Onset of Advanced Age-Related Macular Degeneration. Invest Ophthalmol Vis Sci. 2017; 58(9):3519–3529. https://doi.org/10.1167/iovs.17-21696 PMID:
10.1167/iovs.17-21696 28715590 Crossref Medline, Google Scholar - 13.Kim YK, Ryoo NK, Woo SJ, Park KH. Comparison of visual and anatomical outcomes of half-fluence and half-dose photodynamic therapy in eyes with chronic central serous chorioretinopathy. Graefes Arch Clin Exp Ophthalmol. 2015; 253(12):2063–2073. https://doi.org/10.1007/s00417-014-2926-6 PMID:
10.1007/s00417-014-2926-6 25616728 Crossref Medline, Google Scholar - 14.Rouvas A, Stavrakas P, Theodossiadis PG, Long-term results of half-fluence photodynamic therapy for chronic central serous chorioretinopathy. Eur J Ophthalmol. 2012; 22(3):417–422. https://doi.org/10.5301/ejo.5000051 PMID:
10.5301/ejo.5000051 Crossref Medline, Google Scholar - 15.Daruich A, Matet A, Dirani A, Central serous chorioretinopathy: recent findings and new physiopathology hypothesis. Prog Retin Eye Res. 2015; 48:82–118. https://doi.org/10.1016/j.preteyeres.2015.05.003 PMID:
10.1016/j.preteyeres.2015.05.003 26026923 Crossref Medline, Google Scholar - 16.Lim JI, Glassman AR, Aiello LP, Chakravarthy U, Flaxel CJ, Spaide RFMacula Society CSC Collaborative Study GroupResearch and Education Committee and Website Committee. Collaborative retrospective macula society study of photodynamic therapy for chronic central serous chorioretinopathy. Ophthalmology. 2014; 121(5):1073–1078. https://doi.org/10.1016/j.ophtha.2013.11.040 PMID:
10.1016/j.ophtha.2013.11.040 24439758 Crossref Medline, Google Scholar - 17.Giovansili I, Belange G, Affortit A. Cushing disease revealed by bilateral atypical central serous chorioretinopathy: case report. Endocr Pract. 2013; 19(5):e129–e133. https://doi.org/10.4158/EP12389.CR PMID:
10.4158/EP12389.CR 24013974 Crossref Medline, Google Scholar - 18.Schoenberger SD, Kim SJ. Bilateral Multifocal Central Serous-Like Chorioretinopathy due to MEK Inhibition for Metastatic Cutaneous Melanoma. Case Rep Ophthalmol Med. 2013; 2013:673796. https://doi.org/10.1155/2013/673796 PMID:
23555064 Medline, Google Scholar - 19.Gkotsi D, Gupta M, Lascaratos G, Syrogiannis A, Dhillon B. Alcoholic liver disease and bilateral multifocal central serous retinopathy: a case report. J Med Case Reports. 2013; 7(1):43. https://doi.org/10.1186/1752-1947-7-43 PMID:
10.1186/1752-1947-7-43 Crossref Medline, Google Scholar - 20.Alwassia AA, Adhi M, Duker JS. Bilateral simultaneous central serous chorioretinopathy in a teenage girl with systemic arterial hypertension. Int Ophthalmol. 2013; 33(1):79–82. https://doi.org/10.1007/s10792-012-9624-3 PMID:
10.1007/s10792-012-9624-3 Crossref Medline, Google Scholar - 21.Lai TY, Wong RL, Chan WM. Long-term outcome of half-dose verteporfin photodynamic therapy for the treatment of central serous chorioretinopathy (an American Ophthalmological Society thesis). Trans Am Ophthalmol Soc. 2015; 113:T8. PMID:
26755855 Medline, Google Scholar - 22.Kim SY, Shin DW, Oh KS, Gender differences of occupational stress associated with suicidal ideation among south korean employees: The Kangbuk Samsung Health Study. Psychiatry Investig. 2018; 15(2):156–163. https://doi.org/10.30773/pi.2017.05.31.1 PMID:
10.30773/pi.2017.05.31.1 29475218 Crossref Medline, Google Scholar - 23.Stattin M, Ahmed D, Forster J, Detection of secondary choroidal neovascularization in chronic central serous chorioretinopathy by swept source-optical coherence tomography angiography. Acta Ophthalmol. 2019; 97(1):e135–e136. https://doi.org/10.1111/aos.13855 PMID:
10.1111/aos.13855 Crossref Medline, Google Scholar - 24.Quaranta-El Maftouhi M, El Maftouhi A, Eandi CM. Chronic central serous chorioretinopathy imaged by optical coherence tomographic angiography. Am J Ophthalmol. 2015; 160(3):581–587. e1. https://doi.org/10.1016/j.ajo.2015.06.016 PMID:
10.1016/j.ajo.2015.06.016 26133250 Crossref Medline, Google Scholar - 25.Soomro T, Talks JMedscape. The use of optical coherence tomography angiography for detecting choroidal neovascularization, compared to standard multimodal imaging. Eye (Lond). 2018; 32(4):661–672. https://doi.org/10.1038/eye.2018.2 PMID:
10.1038/eye.2018.2 Crossref Medline, Google Scholar - 26.McClintic SM, Jia Y, Huang D, Bailey ST. Optical coherence tomographic angiography of choroidal neovascularization associated with central serous chorioretinopathy. JAMA Ophthalmol. 2015; 133(10):1212–1214. https://doi.org/10.1001/jamaophthalmol.2015.2126 PMID:
10.1001/jamaophthalmol.2015.2126 26135638 Crossref Medline, Google Scholar - 27.Yaman A, Arikan G, Saatci AO, Cingil G. Choroidal neovascularization following photodynamic therapy in a patient with chronic central serous chorioretinopathy. Bull Soc Belge Ophtalmol. 2007;(303):69–73. PMID:
17894291 Medline, Google Scholar
