Original article
Chronic central serous chorioretinopathy: photodynamic therapy

https://doi.org/10.1016/j.ajo.2004.01.043Get rights and content

Abstract

Purpose

To demonstrate, using optical coherence and fluorescien angiography, the efficacy of photodynamic therapy in treating chronic central serous chorioretinopathy.

Design

Interventional case series.

Methods

A retrospective study in a clinical practice setting of four patients (five eyes) with chronic central serous chorioretinopathy. The patients were treated with verteporfin photodynamic therapy and evaluated by optical coherence tomography and fluorescien angiography with average follow-ups of 10 months.

Results

Compared to pre-treatment optical coherence tomography, an acute reduction in subretinal fluid accumulation and serous detachment with stoppage of leakage was noted in the five eyes treated. Dramatic improvement in visual acuity was also noted, especially among patients with better vision initially. However, pigmentary changes persisted.

Conclusion

Serial optical coherence tomography demonstrates that photodynamic therapy with verteporfin appears to have a beneficial effect in treating patients with chronic central serous chorioretinopathy by reducing fluid leakage, subretinal fluid accumulation, and serous detachment with resultant improvement in vision. Better visual results might be expected if photodynamic therapy is applied earlier in the course of the disease.

Section snippets

Methods

A retrospective study of our clinical practice identified four patients (seven eyes) with chronic CSCR (Table 1 and FIGURE 1, FIGURE 2, FIGURE 3). Two patients had already undergone laser photocoagulation therapy without any improvement. All four patients underwent ophthalmic examination including refraction, Snellen visual acuity testing, color photographs, fluorescein angiography, and optical coherence tomography and determined to have subretinal fluid accumulation, leakage, and serous

Results

The mean age was 58.5 years (range, 46–70 years). Three of the four were male. All patients had a history of CSCR for more than 4 years (mean, 16 years; range, 4–30 years). The initial VA ranged from 20/80 to CF 4′. Two eyes had been treated with laser photocoagulation in the past, but no patient had received laser treatment within 6 months of PDT therapy (Table 1). Photodynamic therapy with verteporfin resulted in rapid resolution of subretinal fluid and serous detachment in all five eyes of

Discussion

The pathophysiology of CSCR is not completely understood. Based on its familial occurrence and progressive, diffuse, bilateral nature, some have suggested that CSCR is an inborn disposition to develop a clinically manifest disintegration of the retinal pigment epithelium in adulthood.23 Others have linked CSCR to corticosteroids, because it has been observed in patients taking corticosteroids, Cushing syndrome, or in other conditions characterized by endogenous hypercortisolism such as type-A

Supplementary files

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