Microperimetric changes and fixation stability status after half-dose photodynamic therapy for chronic central serous chorioretinopathy

2019 ◽  
Vol 30 (5) ◽  
pp. 1053-1060 ◽  
Author(s):  
Samet Gulkas ◽  
Ozlem Sahin

Purpose: The aim of this study was to evaluate the effect of half-dose verteporfin photodynamic therapy on central retinal sensitivity, status of fixation stability, and choroidal thickness in patients with chronic central serous chorioretinopathy. Methods: In total, 22 eyes of 22 patients with chronic central serous chorioretinopathy were enrolled, and all the eyes received indocyanine green angiography-guided half-dose verteporfin photodynamic therapy. Best-corrected visual acuity, contrast sensitivity, and retinal sensitivity in the central 10° and status of the fixation stability are assessed by MAIA microperimetry, and optical coherence tomography findings (central macular thickness and subfoveal choroidal thickness) were evaluated at baseline and 1, 3, and 6 months after the half-dose verteporfin photodynamic therapy. Results: Subretinal fluid was completely resolved in 9 eyes at 1 month and in 17 eyes at 3 months. There was recurrence in two eyes at 6 months and five of the eyes had a persistent subretinal fluid through all the time points. Best-corrected visual acuity, contrast sensitivity, and retinal sensitivity improved significantly 6 months after half-dose verteporfin photodynamic therapy. Fixation stability did not change in either follow-up visit. Central macular thickness and subfoveal choroidal thickness decreased significantly at 6 months of the visits compared to baseline. There was not any systemic and ocular side effect after the treatment. Conclusion: This study shows that there is significant improvement in best-corrected visual acuity, contrast sensitivity, and retinal sensitivity after half-dose verteporfin photodynamic therapy. The status of fixation stability remained unchanged in the eyes with chronic central serous chorioretinopathy after half-dose verteporfin photodynamic therapy. Furthermore, half-dose verteporfin photodynamic therapy is also effective in decreasing central macular thickness and subfoveal choroidal thickness.

2016 ◽  
Vol 2016 ◽  
pp. 1-8 ◽  
Author(s):  
Emin Özmert ◽  
Sibel Demirel ◽  
Özge Yanık ◽  
Figen Batıoğlu

Purpose. To compare the efficacy and safety of subthreshold micropulse yellow wavelength laser (SMYL) and low-fluence photodynamic therapy (PDT) in the treatment of chronic central serous chorioretinopathy (CSC).Methods. Thirty-three eyes of 30 patients with chronic CSC received either PDT (18 eyes) or SMYL (15 eyes) therapy. Best corrected visual acuity (BCVA), subretinal fluid (SRF) height, and central macular thickness (CMT) were evaluated at the baseline visit and one, three, six, nine, and 12 months after the therapy.Results. After 12 months, mean BCVA improved from67.3±14.2to71.5±21.4ETDRS letters in SMYL group and from60.7±16.3to64.4±24.9ETDRS letters in PDT group (p=0.285andp=0.440, resp.). Mean CMT decreased from242.8±80 μm to156.9±60 μm in the PDT group and from287.3±126 μm to138.0±40 μm in the SMYL group (p=0.098andp=0.003, resp.). SRF resolved completely in 72.2% and 80.0% of the eyes in the PDT and SMYL groups, respectively. Mean SRF height decreased from117.2±58 μm to31.3±56 μm in the PDT group and from130.0±104 μm to12.5±21 μm in the SMYL group (p=0.031andp=0.014, resp.).Conclusions. Subthreshold micropulse yellow wavelength laser seems to be effective in the treatment of chronic CSC without any side effect and results in the resorption of SRF without causing visible retinal scarring.


2022 ◽  
Vol 11 (2) ◽  
pp. 323
Author(s):  
Minhee Kim ◽  
Seung Hee Jeon ◽  
Ji-young Lee ◽  
Seung-hoon Lee ◽  
Young-jung Roh

This retrospective study aimed to assess the safety and efficacy of selective retina therapy (SRT) with real-time feedback-controlled dosimetry (RFD) for chronic central serous chorioretinopathy (CSC) and to evaluate factors predictive of treatment response. We included 137 eyes of 135 patients with chronic CSC. SRT was performed to cover each of the leakage areas on fundus fluorescein angiography. Changes in mean best-corrected visual acuity (BCVA), central macular thickness (CMT), and subretinal fluid (SRF) height were evaluated at baseline and at 3 and 6 months after treatment. Complete SRF resolution was observed in 52.6% (72/137 eyes) and 90.5% (124/137 eyes) at 3 and 6 months, respectively. Mean BCVA (logMAR) significantly improved from 0.41 ± 0.31 at baseline to 0.33 ± 0.31 at month 6 (p < 0.001). Mean CMT significantly decreased from 347.67 ± 97.38 μm at baseline to 173.42 ± 30.95 μm at month 6 (p < 0.001). Mean SRF height significantly decreased from 187.85 ± 97.56 µm at baseline to 8.60 ± 31.29 µm after 6 months (p < 0.001). Baseline SRF height was a significant predictive factor for retreatment requirement (p = 0.008). In conclusion, SRT showed favorable anatomical outcomes in patients with chronic CSC. A higher baseline SRF height was a risk factor for retreatment.


2020 ◽  
pp. 1-5
Author(s):  
Kyoko Fujita ◽  
Yutaka Imamura ◽  
Kei Shinoda ◽  
Soiti Matsumoto ◽  
Mitsuko Yuzawa

<b><i>Introduction:</i></b> To evaluate the fundus autofluorescence (FAF) images 1 year after half-dose photodynamic therapy (hdPDT) for chronic central serous chorioretinopathy (CSC). <b><i>Methods:</i></b> Forty-six eyes of 46 consecutive patients with chronic CSC underwent hdPDT. Short wavelength-elicited FAF images and enhanced depth imaging optical coherence tomographic (EDI-OCT) images were recorded before and at 1, 3, 6, 9, and 12 months after the hdPDT. The FAF images at 1 month were compared to those at 12 months after the hdPDT. <b><i>Results:</i></b> The serous retinal detachment (SRD) was resolved in all eyes. The best-corrected visual acuity (BCVA) improved significantly from 0.13 ± 0.28 logarithm of minimum angle of resolution (logMAR) units before to 0.01 ± 0.17 logMAR units at 12 months after the hdPDT (<i>p</i> = 0.001; paired <i>t</i> test). The mean choroidal thickness decreased significantly from 365.4 ± 103.0 µm to 284.3 ± 92.5 µm at 12 months (<i>p</i> &#x3c; 0.001). Abnormal FAF images were present within the irradiated area in all the eyes before the hdPDT. In 5 of 46 eyes, identifiable changes of the FAF images were observed 12 months after hdPDT. None of the eyes had the confluent hypo-FAF type during the follow-up period. Univariate analyses showed that the choroidal thickness before hdPDT correlated significantly with hypo-FAF enlargement (<i>p</i> = 0.005). However, multivariate analyses showed that the association was not significant (<i>p</i> = 0.06). <b><i>Conclusions:</i></b> The progression of the RPE damages occurred in approximately one-tenth of the eyes that underwent hdPDT for chronic CSC. The long-term effect of progression of hypo-FAF on visual functions remains to be determined.


2019 ◽  
Author(s):  
Jianbo Mao ◽  
Caiyun Zhang ◽  
Chenyi Liu ◽  
Lijun Shen ◽  
Jimeng Lao ◽  
...  

Abstract Background: To evaluate the efficacy and safety of conbercept for patients with chronic central serous chorioretinopathy (CSC). Methods: A retrospective clinical study. This study included twenty-seven patients (32 eyes) who were diagnosed with chronic CSC in our hospital from November 2015 to March 2018. All the patients received intravitreal conbercept with one intravitreal injection and pro re nata (PRN). Follow-up observations occurred at 1 week and 1, 2, 3, and 6 months after initial injection. Observed indicators included best-corrected visual acuity (BCVA), central macular thickness (CMT) and presence of subretinal fluid (SRF). Results: During the 6-month follow-up, the mean number of injections required and performed was 1.50±0.67. The BCVA at the first visit, 1-week, 1-, 2-, 3- and 6-month follow-ups after the first injection was 0.44±0.26, 0.39±0.29, 0.38±0.29, 0.33±0.29, 0.31±0.30, and 0.31±0.29, respectively. The difference between the BCVA at each follow-up and the first visit was statistically significant (F=9.717, P<0.05). CMT at the first visit, 1-week, 1-, 2-, 3- and 6- month after first injection was 323.25±158.49μm, 263.78±122.52μm, 222.34±92.46μm, 195.63±69.18μm, 189.25±68.71μm, and 200.47±86.30μm, respectively. The difference between the CMT at each follow-up and the first visit was also statistically significant (F=17.072, P<0.05). Full resolution of fluid was achieved in 7 (21.9%) eyes at 1 month, 14 (43.8%) eyes at 2 months, 19 (59.4%) eyes at 3 months and 23 (71.9%) eyes at 6 months after the initial treatment of anti-VEGF injection. No severe adverse event was noted relevant to the therapy. Conclusion: Intravitreal injection of conbercept can effectively reduce the CMT and improve the BCVA in chronic CSC in a short term of 6 months. Keywords: Chronic central serous chorioretinopathy, Conbercept, Best-corrected visual acuity, Central macular thickness.


2020 ◽  
Author(s):  
Pichai Jirarattanasopa ◽  
Banchasakjaroen Vanchalerm ◽  
Ratanasukon Mansing

Abstract Background To compare the efficacy of half-dose photodynamic therapy (PDT) and one-third-dose PDT in chronic or recurrent central serous chorioretinopathy (CSC). Methods A retrospective review of patients with chronic or recurrent CSC who were treated with half-dose or one-third-dose PDT and followed for 12 months afterwards. Best-corrected visual acuity (BCVA), central retinal thickness (CRT) and resolution of subretinal fluid (SRF) at baseline and 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 = 0.293) and CRT improvement (125.6 ± 24.6 µm for one-third-dose versus 139.1 ± 16.54 for half-dose, P = 0.652) 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 term 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.


2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Jirarattanasopa Pichai ◽  
Banchasakjaroen Vanchalerm ◽  
Ratanasukon Mansing

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.


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