Outcome of half-dose photodynamic therapy in chronic central serous chorioretinopathy with fovea-involving atrophy
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Outcome of half-dose photodynamic therapy in chronic central serous chorioretinopathy with fovea-involving atrophy Thomas J. van Rijssen 1 & Elon H. C. van Dijk 1 & Paula Scholz 2 & Robert E. MacLaren 3 & Sascha Fauser 2,4 & Susan M. Downes 3 & Carel B. Hoyng 5 & Camiel J. F. Boon 1,6 Received: 2 July 2020 / Revised: 14 September 2020 / Accepted: 1 October 2020 # The Author(s) 2020
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.
Key messages Half-dose photodynamic therapy is an effective treatment in chronic central serous chorioretinopathy In chronic central serous chorioretinopathy with fovea-involving atrophy, half-dose photodynamic therapy may lead to recovery of neuroretinal anatomy, but with limited functional effects Chronic central serous chorioretinopathy should ideally be treated before the occurrence of fovea-involving atrophy
Keywords Central serous chorioretinopathy . Foveal atrophy . Photodynamic therapy . Fluorescein angiography
* Camiel J. F. Boon [email protected] 1
Department of Ophthalmology, Leiden University Medical Center, P.O. Box 9600, 2300 RC Leiden, The Netherlands
2
Department of Ophthalmology, University Hospital of Cologne, Cologne, Germany
3
Oxford Eye Hospital, John Radcliffe Hospital, Oxford University Hospitals NHS Foundation Trust, West Wing, Oxford, UK
4
F. Hoffmann-La Roche, Basel, Switzerland
5
Department of Ophthalmology, Radboud University Medical Center, Nijmegen, The Netherlands
6
Amsterdam University Medical Centers, Academic Medical Center, Department of Ophthalmology, University of Amsterdam, Amsterdam, The Netherlands
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