scholarly journals Choroidal Volume Evaluation after Photodynamic Therapy Using New Optical Coherence Tomography Imaging Algorithm

2021 ◽  
Vol 14 (11) ◽  
pp. 1140
Author(s):  
Miki Sato-Akushichi ◽  
Shinji Ono ◽  
Gerd Klose ◽  
Youngseok Song

To evaluate choroidal volume and thickness changes after photodynamic therapy (PDT) for chronic central serous chorioretinopathy (CSC). Chronic CSC eyes with a history of PDT were selected. Average choroidal volume, average choroidal thickness, the maximum and minimum choroidal thickness of the macula irradiated area and peripheral non-irradiated areas before and after one and three months of treatment were examined. A total of 14 patients with chronic CSC and 9 controls without any eye pathology were enrolled. The mean choroidal volume in CSC before and, and after one and three months of treatment were 2.36 (standard deviation: 0.70), 1.90 (0.69), 1.86 (0.66) mm3 for the central area, 1.25 (0.38), 1.14 (0.35), 1.13 (0.34) mm3 for superior nasal area, 1.47 (0.41), 1.28 (0.43), 1.26 (0.43) mm3 for superior temporal area, 1.07 (0.49), 0.95 (0.38), 0.93 (0.35) mm3 for inferior nasal area, 1.17 (0.38), 1.04 (0.32), 1.03 (0.33) mm3 for inferior temporal area. This study revealed the choroidal volume changes in a short period after PDT and a decrease in unirradiated choroidal volume was also shown after the treatment. The algorithm provided on the ARI Network enables to evaluate the choroidal changes quantitatively and qualitatively.

2020 ◽  
pp. bjophthalmol-2020-316076 ◽  
Author(s):  
Mary Ho ◽  
Frank Hiu Ping Lai ◽  
Danny Siu Chun Ng ◽  
Lawrence Pui Leung Iu ◽  
Li Jia Chen ◽  
...  

PurposeThe purpose of this study was to investigate the signal changes in choriocapillaris flow deficits and choroidal thickness changes using swept-source optical coherence tomography angiography (OCTA) following different treatments.DesignA double-blind, randomised controlled trial.MethodsPatients with unilateral chronic central serous chorioretinopathy (CSC) were randomised to receive subthreshold micropulse laser therapy (MLT) or half-dose photodynamic therapy (PDT). Choroidal thickness and choriocapillaris flow deficit signals were investigated.ResultsEighteen patients were randomised into the MLT group and 15 patients into the PDT group. Areas with flow deficit signals were identified in all baseline OCTA images of the choriocapillaris, with mean areas of 0.420 and 0.465 mm2 in the MLT and PDT groups, respectively. These flow deficit signal areas were significantly reduced at 6 months (p=0.011) in the MLT group and at 3 months (p=0.008) in the PDT group. Patients from the PDT group were shown to have smaller flow deficit areas than patients from the MLT group at all time points after treatment (p=0.001, analyses of variance). The mean choroidal volume of the fovea showed a significant reduction at 1 month (p=0.003), 3 months (p=0.199) and 6 months (p=0.006) in the PDT group.ConclusionThe flow deficit areas identified in the choriocapillaris layer may suggest possible relative choroidal ischaemia. With measurement of choroidal volume reduction and faster rates of flow deficit area change, PDT has a stronger effect than MLT in promoting choriocapillaris recovery.


2020 ◽  
Vol 75 (6) ◽  
pp. 298-308
Author(s):  
Kateřina Manethová ◽  
Jan Ernest ◽  
Michal Hrevuš ◽  
Naďa Jirásková

Purpose: The aim of this prospective clinical study was to evaluate the anatomical and functional results of the treatment of 54 eyes with chronic form of central serous chorioretinopathy (CSC) using photodynamic therapy in a reduced (half) verteporfin (HD-PDT) dosing regimen. Materials and Methods: Our prospective study included 54 eyes of 52 patients (40 males, 12 females) at an average age of 50.1 years (median 49.5, range 30–75 years) treated at the Ophthalmology Clinic of the First Faculty of Medicine and Military University Hospital in Prague from January 2012 to January 2018 for chronic form of CSC with a minimum disease duration of 3 months. In our study, we evaluated the improvement of the best corrected visual acuity (BCVA) and central retinal thickness (CRT) before treatment and at 1, 3, 6 and 12 months after HD-PDT. Results: The mean baseline BCVA was 68.91 ± 10.5 ETDRS letters (median 71; range 35–85) and the mean baseline CRT was 385.6 ± 118.5 µm (median 367, 5 µm; range 245–1000 µm). At the end of the follow-up period, the average BCVA was 79 ± 11 ETDRS letters (median 82; range 38–93). The improvement in BCVA before and after treatment was statistically significant in all measurements (p < 0.0001). The mean CRT at the end of the follow-up period was 263.5 ± 52 µm (median 258.5 µm; range 162–404 µm). The decrease in CRT at all timepoints was statistically significant compared to baseline (p < 0.0001). In our set of patients, at the end of the follow-up period, the retinal finding was improved or stabilized in 50 eyes (92.6 %). In this study, we observed in 2 cases the development of secondary choroidal neovascularization (CNV). Conclusion: HD-PDT is a long-term safe and effective method of treating chronic forms of CSC. However, despite a reduced dose of verteporfin, complications may occur.


2021 ◽  
pp. 112067212199105
Author(s):  
George Manayath ◽  
Shishir Verghese ◽  
Ratnesh Ranjan ◽  
Hitesh Agrawal ◽  
Amishi Khanna ◽  
...  

Aims: To compare the long-term outcomes in chronic central serous chorioretinopathy (cCSC) following half-fluence photodynamic therapy (HF-PDT) and oral eplerenone treatment. Methods: This retrospective comparative study included consecutive patients of cCSC treated with either HF-PDT or eplerenone. The treatment outcomes of the two groups were analyzed at 3-month, 6-month, and 12-month post-treatment. Results: This study included 20 eyes (20 patients) in HF-PDT group, and 18 eyes (18 patients) in eplerenone group. All baseline parameters in HF-PDT and eplerenone groups were comparable including neurosensory detachment height (217.05 ± 140.25 µm vs 178.05 ± 164.24 µm respectively, p = 0.09), best-corrected visual acuity (BCVA) (logMAR 0.24 ± 0.13 vs logMAR 0.46 ± 0.37 respectively, p = 0.1), and subfoveal choroidal thickness (SFCT) [427.4 ± 117.4 µm vs 456.38 ± 119.25 µm respectively, p = 0.45]. HF-PDT resulted in complete resolution of neurosensory detachment in higher proportion of eyes compared to eplerenone at each follow-up visits (3 months: 90% vs 27.7%, p = 0; 6 months: 100% vs 61.1%, p = 0.003; and 12 months: 100% vs 70%, p = 0.03) with a significantly shorter duration to resolution (3.3 ± 0.9 months vs 5.8 ± 3.3 months respectively, p = 0.02). Intergroup comparison showed no significant difference between mean BCVA ( p = 0.38 at 3 months, p = 0.14 at 6 months, and p = 0.19 at 12 months). Mean SFCT at 12 months of the two groups differed significantly ( p = 0.003) due to increased choroidal thickness of eplerenone group. Conclusion: HF-PDT has a superior efficacy to achieve faster, greater and long-lasting resolution of subretinal fluid in cCSC compared to eplerenone therapy.


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.


2009 ◽  
Vol 27 (15_suppl) ◽  
pp. e14646-e14646
Author(s):  
O. N. Kozyreva ◽  
N. Konnikov

e14646 Background: Non-melanoma skin cancer (NMSC) is the most common form of human cancer. Aminolevulinic acid photodynamic therapy (ALA PDT) is a safe and effective treatment for NMSC precursors. It is unknown if ALA PDT treatment will affect incidence of NMSC in high risk patients (pts). Methods: A retrospective study was undertaken using a Veteran Affairs Boston Health Care System Medical Record Database. Study population included immunocompetent pts with history of NMSC, multiple actinic keratosis (AKs), and moderate to severe dermatoheliosis (DH). Study pts received a single application of 20 % ALA to the face or scalp following by exposure to blue light at 10 J/cm2. Differences in incidence of NMSC two years prior and two years after ALA PDT were tested using the Wilcoxon rank sum test. Data were analyzed by the median and interquartile range (IQR). Results: 43 Caucasian males (range 59- 87 yrs), 37 (87%) had history of NMSC on the face or scalp, 32 (78%) had basal cell carcinoma (BCC), 11 (22%) squamous cell carcinoma (SCC), 100% of patients had multiple (>4) AKs prior to treatment and 23 (75% ) had moderate to severe DH determined by Griffiths scale. Prior to ALA-PDT 74 NMSC's were documented: 40 (54%) BCC and 34 (46%) SCC. 46 NMSC's were documented following ALA-PDT: 22 (48%) BCC and 24 (52%) SCC. Prior to ALA-PDT, the frequency of BCC averaged 2 [IQR 1 to 3, max=4], and the frequency of SCC averaged 1 [IQR 1 to 1, max=3]. Following ALA-PDT, the occurrence of BCC averaged 1 [IQR 0 to 1, max=5], and that of SCC averaged 1 [IQR 0 to 2, max= 4]. The difference between BCC frequency before and after ALA-PDT treatment shown a significant reduction in BCC incidence (P = 0.0018). No such differences were observed between the frequency of SCC before and after ALA-PDT (P=0.6230) Conclusions: A single ALA-PDT treatment to the face or scalp in high risk patients significantly reduces the incidence of BCC, the incidence of SCC was not reduced. The potential role of ALA PDT as a NMSC chemopreventive modality warrants further investigation in larger samples with an alternative treatment protocols. No significant financial relationships to disclose.


2021 ◽  
pp. 112067212110213
Author(s):  
Kobra Nasrollahi ◽  
Fatemeh Razmjoo ◽  
Morteza Naderan ◽  
Alireza Peyman

Purpose: To investigate the possible structural changes of the central choroid and retina after collagen cross-linking (CXL) in patients with progressive keratoconus (KCN). Methods: Twenty-five eyes of 25 patients were included in this study. Patients underwent enhanced depth imaging optical coherence tomography (EDI-OCT) before and 1 month after CXL. The values for central macular thickness (CMT), subfoveal choroidal thickness (CHT), and choroidal volume (CHV) were evaluated. Results: CMT before and after CXL was 263.24 ± 16.25 μm and 263.20 ± 16.51 μm, respectively ( p = 0.98). CHT was 362.08 ± 36.80 μm and 367.84 ± 33.67 μm before and after CXL, respectively ( p = 0.26). CHV was 8.74 ± 0.33 mm3 and 8.68 ± 0.36 mm3 before and after CXL, respectively ( p = 0.11). There was no significant difference in the corrected distance visual acuity before and after CXL (0.06 ± 0.05 and 0.05 ± 0.05 logMAR, respectively, p = 0.65). Conclusion: Central retinal and choroidal thicknesses are not changed after corneal cross- linking.


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