scholarly journals 3-year follow-up of half-dose verteporfin photodynamic therapy for central serous chorioretinopathy with OCT-angiography detected choroidal neovascularization

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Yu-Chen Hu ◽  
Yi-Ling Chen ◽  
Yen-Chih Chen ◽  
San-Ni Chen
Keyword(s):  
Photodynamic Therapy ◽  
Choroidal Neovascularization ◽  
Central Serous Chorioretinopathy ◽  
Subretinal Fluid ◽  
Anti Vegf ◽  
Half Dose ◽  
The Mean ◽  
Group 2 ◽  
Endothelial Growth Factor ◽  
Group 1

AbstractTo assess the 3-year outcome of half-dose verteporfin photodynamic therapy (PDT) in central serous chorioretinopathy (CSC) with optical coherence tomography angiography (OCT-A) detected choroidal neovascularization (CNV), we performed a retrospective, interventional study. Patients were divided into 2 groups according to the fluorescein angiography: point source leakage in group 1 and diffuse oozing in group 2. Data were collected from patients including changes of best-corrected visual acuity (BCVA), size of CNV, central macular thickness (CMT), choroidal thickness (CT), reabsorption of subretinal fluid (SRF), sessions of half-dose PDT, and the number of intravitreal injections (IVI) of anti-vascular endothelial growth factor (anti-VEGF). There was a total of 34 eyes in 32 patients included. The mean sessions of half-dose PDT was 1.50 ± 0.75. The mean number of IVI of anti-VEGF was 1.38 ± 3.34. BCVA improved from 0.38 ± 0.33 to 0.20 ± 0.22 (p < 0.001). Mean CMT was significantly reduced along with reduced CT and increased size of CNV. SRF was totally reabsorbed in 31 eyes. Patients in group 1 had significant less sessions of PDT and better final BCVA. In conclusion, half-dose PDT treatment was effective for CSC with CNV. Patients with diffuse oozing in FA may fare less well with half-dose PDT.

Treatment outcomes of photodynamic therapy and findings predicting treatment success in pachychoroid-associated neovascularization

2021 ◽  
pp. 112067212110334
Author(s):  
Sibel Demirel ◽  
Özge Yanık ◽  
Figen Batıoğlu ◽  
Emin Özmert
Keyword(s):  
Photodynamic Therapy ◽  
Predictive Factors ◽  
Choroidal Thickness ◽  
Treatment Success ◽  
Subretinal Fluid ◽  
Luminal Area ◽  
The Mean ◽  
Baseline Characteristics ◽  
Group 2 ◽  
Group 1

Purpose: To investigate the treatment outcomes and predictive factors affecting treatment success of half-fluence photodynamic therapy (hf-PDT) in pachychoroid-associated neovascularization (PNV). Methods: Twenty-four eyes of 23 PNV patients who underwent hf-PDT were included in this study. The results of optical coherence tomography (OCT) and OCT-angiography imaging were analyzed. The total choroidal area (CA), luminal area (LA), and stromal area (SA) were measured using ImageJ software. Baseline characteristics of the eyes showing complete response (group 1) and the eyes with partial response or unresponsive to hf-PDT (group 2) were compared. Results: The mean age of the patients was 54.2±9.6 years. The mean follow-up time after hf-PDT was 20.7 ± 13.6 months. Three months after hf-PDT, the subretinal fluid had completely regressed in 18 eyes (75.0%), partial resolution was observed in 3 eyes (12.5%), and 3 eyes (12.5%) were unresponsive to hf-PDT. When the baseline characteristics before hf-PDT were evaluated between the groups, the mean central choroidal thickness (411.5 ± 115.1 µm vs 284.8 ± 69.4 µm), the mean CA (1.082 ± 0.315 mm2 vs 0.795 ± 0.242 mm2) and the mean LA (0.795 ± 0.234 mm2 vs 0.578 ± 0.200 mm2) was significantly higher in group 1 compared to group 2 ( p = 0.019, p = 0.018, p = 0.018, respectively). Conclusion: Hf-PDT is an effective treatment method usually providing total resolution of subretinal fluid in PNV cases. A high baseline central choroidal thickness and large luminal area may be positive predictive factors in terms of full anatomical response to hf-PDT. It may be possible to plan a more effective treatment strategy by keeping these factors in mind.

scholarly journals Adjunct Intravitreous Triamcinolone Acetonide in the Treatment of Diabetic Macular Edema with Anti-VEGF Agents

2016 ◽  
Vol 2016 ◽  
pp. 1-6 ◽  
Author(s):  
Robert B. Garoon ◽  
Robert E. Coffee ◽  
Lai Jiang ◽  
Christina Y. Weng ◽  
Petros E. Carvounis
Keyword(s):  
Macular Edema ◽  
Triamcinolone Acetonide ◽  
Diabetic Macular Edema ◽  
Anti Vegf ◽  
Treatment Naïve ◽  
The Mean ◽  
Group 2 ◽  
Endothelial Growth Factor ◽  
Phakic Eyes ◽  
Group 1

Aims.To compare visual and anatomic outcomes of adjunct intravitreous (IVT) triamcinolone acetonide to antivascular endothelial growth factor (VEGF) injections to IVT anti-VEGF injections alone for center-involving diabetic macular edema (DME) in treatment-naïve eyes.Methods.Retrospective study of treatment-naïve eyes with center-involving DME. The primary outcome was the change in best corrected visual acuity (BCVA) in eyes receiving only IVT anti-VEGF (group 1) and eyes receiving IVT anti-VEGF and adjunct IVT-TA (group 2).Results.Included were 192 eyes. The mean change in BCVA was +3.5 letters in group 1 compared to −3.5 letters in group 2 (p=0.048). Final macular thickness improved by −94 μm in group 1 versus −68 μm in group 2 (p=0.26). In group 1, 5/150 eyes compared to 9/42 eyes in group 2 (3.3% versus 21%,p=0.0005) had a IOP >10 mmHg increase. Six of 126 phakic eyes in group 1 versus 12/33 phakic eyes in group 2 underwent cataract surgery (4.7% versus 36.3%,p=0.00009).Conclusions.IVT-TA results in no additional benefit in eyes treated with anti-VEGF agents for DME.

Intravitreal Anti-VEGF Treatment of Myopic Choroidal Neovascularization

2017 ◽  
Vol 1 (2) ◽  
pp. 109-115
Author(s):  
Daniel R. Moroz ◽  
Monique Munro ◽  
Michael P. Fielden
Keyword(s):  
Visual Acuity ◽  
Choroidal Neovascularization ◽  
Age Related Macular Degeneration ◽  
Myopic Choroidal Neovascularization ◽  
Anti Vegf ◽  
Age Related ◽  
Significant Difference ◽  
The Mean ◽  
Group 2 ◽  
Group 1

Purpose: To determine whether the presenting clinical features of active myopic choroidal neovascularization (CNV), including the presence of fibrosis or atrophy, limit the ultimate visual acuity gains from intravitreal anti-vascular endothelial growth factor (anti-VEGF) therapy. Methods: A retrospective analysis of 42 eyes with new-onset subfoveal CNV was performed. Only patients without concurrent age-related macular degeneration and with a spherical equivalent of at least −6.0 diopters were included in the study. All eyes received either intravitreal ranibizumab or bevacizumab injections as the primary treatment on a pro re nata basis for 1 year. Changes in best-corrected visual acuity (BCVA) and central retinal thickness (CRT) were recorded. Results: The mean number of ranibizumab (18 eyes) or bevacizumab (24 eyes) injections was 4.7 ± 0.5 over a mean follow-up time of 12 ± 0.4 months. The mean age of the patients was 62 ± 2.0 years. Based on optical coherence tomography staging at the initiation of treatment for active CNV, 30 had no fibrosis or atrophy (group 1), 5 had fibrotic stage, and 7 had atrophic stage CNV (the latter combined to form group 2). The BCVA for group 1 improved significantly ( P < .02) but worsened for group 2 ( P < .38), a statistically significant difference ( P < .05). The CRT for group 1 also declined significantly more than for group 2 ( P < .014). Conclusion: The presence of fibrosis or atrophy in eyes with active myopic CNV at the initiation of anti-VEGF therapy was associated with limited anatomic outcomes and visual gain.

scholarly journals One-year results of half-dose versus one-third-dose photodynamic therapy in chronic or recurrent central serous chorioretinopathy

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Jirarattanasopa Pichai ◽  
Banchasakjaroen Vanchalerm ◽  
Ratanasukon Mansing
Keyword(s):  
Photodynamic Therapy ◽  
Recurrence Rate ◽  
Central Serous Chorioretinopathy ◽  
Subretinal Fluid ◽  
Corrected Visual Acuity ◽  
Half Dose ◽  
One Year ◽  
The One ◽  
Different Doses

Abstract Background Central serous chorioretinopathy (CSC) is characterized by an accumulation of subretinal fluid (SRF) in the macula. It is usually treated by laser photocoagulation or photodynamic therapy (PDT) with consisting of different doses and power. This study aimed to compare the efficacy of half-dose PDT and one-third-dose PDT in chronic or recurrent CSC. Methods A retrospective review of patients with chronic or recurrent CSC who were treated with either a half-dose or one-third-dose PDT, and had follow up 12 months afterwards. Best-corrected visual acuity (BCVA), central retinal thickness (CRT) and resolution of subretinal fluid (SRF) at baseline as well as 1, 3, 6 and 12 months post-PDT were assessed. Results Forty-six eyes and 20 eyes received half-dose and one-third-dose PDT, respectively. The study showed efficacy of the one-third-dose PDT compared with half-dose PDT in BCVA improvement (0.10±0.04 logMAR for one-third-dose versus 0.17±0.04, for half-dose, P=0.148) and CRT improvement (125.6±24.6 μm for one-third-dose versus 139.1±16.54, for half-dose, P=0.933) at 12 months. The SRF recurrence rate was significantly higher in the one-third-dose PDT group compared with the half-dose PDT group (40.0% versus 15.2%, P=0.027) at 12-months. Conclusion At 12 months, the one-third-dose PDT was effective in terms of BCVA and CRT improvement, when compared with half-dose PDT. However, this study showed that one-third-dose PDT had a higher recurrence rate of SRF.

scholarly journals Comprehensive evaluation of intravitreal conbercept versus half-dose photodynamic therapy for chronic central serous chorioretinopathy

2021 ◽  
Vol 14 (5) ◽  
pp. 719-724
Author(s):  
Jian-Bo Mao ◽  
◽  
Chen-Yi Liu ◽  
Yun Zhang ◽  
Jing-Jing Lin ◽  
...  
Keyword(s):  
Photodynamic Therapy ◽  
Central Serous Chorioretinopathy ◽  
Comprehensive Evaluation ◽  
Subretinal Fluid ◽  
Chronic Central Serous Chorioretinopathy ◽  
Treatment Groups ◽  
Full Resolution ◽  
Long Term Effect ◽  
Half Dose

AIM: To compare the safety and efficacy of conbercept intravitreal injection and half-dose photodynamic therapy (PDT) in treating chronic central serous chorioretinopathy (CSC). METHODS: This study was retrospective. Thirty-seven patients (37 eyes) with chronic CSC received conbercept injections while 57 patients (57 eyes) were treated with half-dose PDT. All subjects were followed in 6mo. Outcome measures included change in best-corrected visual acuity (BCVA), central macular thickness (CMT), subfoveal choroidal thickness (SFCT), and resolution of subretinal fluid (SRF). RESULTS: There was no adverse event observed in either treatment group. At the 6-month follow-up, 26 eyes (70.3%) in the conbercept group and 54 eyes (94.7%) in the half-dose PDT group (P&#x003C;0.05) reached full resolution of SRF. The mean logarithm of the minimum angle of resolution (logMAR) BCVA significantly improved (P&#x003C;0.001) in both treatment groups with better outcome at early phase in the half-dose PDT group (2wk, 1, and 2mo, P&#x003C;0.05). All subjects experienced significant CMT improvement (P&#x003C;0.001) with no statistical difference between the two groups (P&#x003E;0.05). The SFCT also improved in all subjects (P&#x003C;0.001) with better outcome in the half-dose PDT group (P&#x003C;0.05). CONCLUSION: Both intravitreal conbercept and half-dose PDT are safe to use in treating chronic CSC. By 6mo, both treatment groups are efficacious in improving BCVA, reducing CMT and SFCT, and resolving SRF in eyes with chronic CSC. Half-dose PDT may show better outcome at initial phase of treatment in chronic CSC. Longer follow-up period is necessary to study for long-term effect and safety.

scholarly journals Central Serous Chorioretinopathy And Selective Serotonin Reuptake Inhibitors

2020 ◽  
Author(s):  
Ahmet ALTUN ◽  
Fatih Atmaca ◽  
Ahmet Icagasioglu ◽  
Selcuk Cekmeceli
Keyword(s):  
Central Serous Chorioretinopathy ◽  
Serotonin Reuptake ◽  
Complete Resolution ◽  
Selective Serotonin Reuptake Inhibitors ◽  
Antidepressant Drug ◽  
Subretinal Fluid ◽  
Selective Serotonin ◽  
Group 3 ◽  
Group 2 ◽  
Group 1

Abstract Aim: To investigate the relationship between central serous chorioretinopathy (CSC) and selective serotonin reuptake inhibitor (SSRI) antidepressant drugs.Methods: The files of patients diagnosed with CSC who applied to our clinics were analyzed retrospectively. Group 1 was formed from patients who had never used any antidepressant drug. Group 2 and Group 3 were composed of patients who did not stop and stopped using SSRI after the third month, respectively. Ophthalmological examinations, optical coherence tomography and fundus fluorescein angiography images of the patients were analyzed and the groups were compared with each other. Results: Group 1, Group 2 and Group 3 had 122, 8, 12 eyes, respectively. The time for complete resolution of subretinal fluid (SRF) in Group 3 was statistically significantly shorter than Group 1 and Group 2 (p ˂ 0.01). In Group 2, the time for complete resolution of SRF was significantly longer than Group 1 (p ˂ 0.05). Conclusion: SSRI group antidepressant drugs might be an important factor in CSC etiology and prognosis. Discontinuation of these drugs may accelerate subretinal fluid resolution.

Pharmacotherapy for Choroidal Neovascularization Due to Uncommon Causes

2019 ◽  
Vol 24 (41) ◽  
pp. 4882-4895
Author(s):  
Christine P.S. Ho ◽  
Timothy Y.Y. Lai
Keyword(s):  
Effective Treatment ◽  
Choroidal Neovascularization ◽  
Case Series ◽  
Subretinal Fluid ◽  
Age Related Macular Degeneration ◽  
Pathologic Myopia ◽  
Effective Treatment Option ◽  
Anti Vegf ◽  
Age Related ◽  
Endothelial Growth Factor

Background: Choroidal neovascularization (CNV) in adults is most commonly associated with neovascular age-related macular degeneration (AMD) and pathologic myopia. Though less common, CNV can also develop from other conditions such as uveitis, central serous chorioretinopathy, angioid streaks, intraocular tumors, hereditary chorioretinal dystrophies, or can be idiopathic in origin. If left untreated, CNV may cause visual loss because of exudation of intraretinal or subretinal fluid, retinal or subretinal hemorrhage, or fibrosis involving the macula. It is well known that one of the main drivers of angiogenesis in CNV development is vascular endothelial growth factor (VEGF) and therefore inhibitors of VEGF might be an effective treatment for CNV. Methods: The goal of this review is to provide an overview and summary in the use of pharmacotherapy especially anti-VEGF therapy, in the treatment of CNV due to uncommon causes. Results: Results from uncontrolled case series and controlled clinical trials have reported good efficacy and safety in using anti-VEGF agents including bevacizumab, ranibizumab, aflibercept and ziv-aflibercept in the treatment of CNV due to uncommon causes. Anti-VEGF has also been used in combination with verteporfin PDT and anti-inflammatory agents for treating CNV of various causes. Conclusion: Pharmacotherapy with anti-VEGF agents is an effective treatment option for CNV due to uncommon etiologies.

scholarly journals Outcome of half-dose photodynamic therapy in chronic central serous chorioretinopathy with fovea-involving atrophy

2020 ◽  
Author(s):  
Thomas J. van Rijssen ◽  
Elon H. C. van Dijk ◽  
Paula Scholz ◽  
Robert E. MacLaren ◽  
Sascha Fauser ◽  
...  
Keyword(s):  
Photodynamic Therapy ◽  
Central Serous Chorioretinopathy ◽  
Multimodal Imaging ◽  
Pigment Epithelium ◽  
Retinal Pigment ◽  
Final Visit ◽  
Chronic Central Serous Chorioretinopathy ◽  
Half Dose ◽  
Rpe Atrophy ◽  
The Mean

Abstract 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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