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Prognostic factors related to photodynamic therapy for central serous chorioretinopathy

  • Retinal Disorders
  • Published:
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Abstract

Background

To investigate the effects and prognostic factors related to photodynamic therapy (PDT) for central serous chorioretinopathy (CSC).

Methods

Retrospective medical record reviewing of consecutive CSC patients (chronic or persistent typical CSC) treated with conventional PDT (full-dose verteporfin, laser (689 nm) delivery for 83 s, total light energy of 50 J/cm2) was performed. Besides overall anatomic and functional outcomes, the prognostic influences of various baseline factors (sex, age, duration of symptoms, presence of focal leak and pigment epithelial detachment (PED), SRF size, confluent RPE atrophy, PDT spot size), disintegrity of the junction between foveal outer and inner photoreceptor layer (OS-IS) after resolution, and post-treatment RPE changes on outcomes were evaluated.

Results

Forty patients (41 eyes) were included. Anatomic success, defined as complete resolution of serous fluid on optical coherence tomography performed 4–6 weeks after PDT, was achieved in 87.8% of eyes, and visual acuity improved significantly (0.19 ± 0.24 lines). Visual acuity had improved more than one line in 46.3% of the patients and decreased more than one line in 14.6% of patients at the 1-month follow-up visit. Prolonged symptom duration (> 9 months), PED, confluent RPE atrophy, foveal OS-IS disintegrity, and post-PDT RPE changes were associated significantly with visual loss of more than three lines and foveal atrophy. Central macular thickness was significantly reduced in patients treated with PDT compared to those treated with focal laser.

Conclusions

PDT for CSC was effective with regard to anatomic and functional outcomes. However, visual improvement may be limited in patients with prolonged symptom duration, baseline confluent RPE atrophy, foveal OS-IS disintegrity, or progression of RPE atrophy after PDT and the risk of PDT-induced foveal injury should be considered.

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Author information

Authors and Affiliations

  1. Department of Ophthalmology, Seoul National University College of Medicine, Seoul, Korea

    Jun Woong Moon, Hyeong Gon Yu, Tae Wan Kim & Hum Chung

  2. Department of Ophthalmology, Seoul National University Hospital, #28 Yongon-dong, Chongno-gu, Seoul, 110-744, Korea

    Hyeong Gon Yu

  3. Sensory Organs Institute, Medical Research Center, Seoul National University, Seoul, Korea

    Hyeong Gon Yu

  4. Department of Ophthalmology, Konkuk University Hospital, Seoul, Korea

    Jun Woong Moon & Hyung Chan Kim

Authors
  1. Jun Woong Moon
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  2. Hyeong Gon Yu
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  3. Tae Wan Kim
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  4. Hyung Chan Kim
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  5. Hum Chung
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Corresponding author

Correspondence to Hyeong Gon Yu.

Additional information

“This study was supported by grants from the Korea Healthcare technology R&D Project, Ministry for Health, Welfare & Family Affairs, Republic of Korea (A080588).” The authors have full control of all primary data and agree to allow Graefe’s Archive for Clinical and Experimental Ophthalmology to review their data if requested.

Summary statement. Though photodynamic therapy enhances rapid anatomic resolution and visual recovery in central serous chorioretinopathy, visual recovery may be restricted in patients with prolonged duration or post-treatment RPE changes. Also, foveal injury from PDT might occur.

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Moon, J.W., Yu, H.G., Kim, T.W. et al. Prognostic factors related to photodynamic therapy for central serous chorioretinopathy. Graefes Arch Clin Exp Ophthalmol 247, 1315–1323 (2009). https://doi.org/10.1007/s00417-009-1104-8

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  • DOI: https://doi.org/10.1007/s00417-009-1104-8

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