A two-year study of diffused retinal pigment epitheliopathy treated with half-dose photodynamic therapy guided by simultaneous angiography and optical coherence tomography

Yang Liu,Elena Yingqiu Zhu,Lei Li,Wenji Wang,Gezhi Xu,Yuanzhi Yuan

doi:10.1038/s41433-018-0284-z

Abstract

ObjectivesDiffused retinal pigment epitheliopathy (DRPE) is not necessarily the same as chronic central serous chorioretinopathy (CSC), but a severe subgroup under the umbrella of chronic CSC. This study was to evaluate the efficacy and safety of half-dose PDT treating DRPE.MethodsA retrospective case series design was used. Forty-eight consecutive patients (48 eyes) with DRPE treated with half-dose PDT underwent follow-up at baseline, 3 months, 6 months, 12 months and 24 months. Simultaneous FA, ICGA and OCT were used for the treatment and follow-up. The primary outcomes were the subretinal fluid and best-corrected visual acuity in optical coherence tomography.ResultsComplete fluid absorption was achieved in 95.8% of eyes at 3 months and 100.0% of eyes at 24 months. The baseline logarithm of the minimum angle of resolution (logMAR) BCVA, which was 0.51 ± 0.36, significantly improved to 0.43 ± 0.38 (p < 0.001) at 6 months. The boost continued to 0.29 ± 0.37 (p < 0.001) at 12 months and 0.19 ± 0.39 (p < 0.001) at 24 months. The integrities of the ellipsoid zone (EZ) and interdigitation zone (IZ) improved throughout. Regression analyses showed the BCVA in logMAR was inversely correlated with the EZ (p < 0.01) and IZ (p < 0.01). The recurrence rate was 6.3%. No severe complications were witnessed.ConclusionsIn 48 eyes with DRPE, simultaneous angiography and OCT facilitated a more comprehensive guidance for half-dose PDT treatment and follow-up. The BCVA improvement occurred at 6 months, which may be attributed to the restoration of the outer retinal structure.

Highlights

These authors contributed : Lei Li, Gezhi XuCentral serous chorioretinopathy (CSC) is defined as a serous exudative detachment of the retina, usually confined to the macula, and it exhibits a variety of visual manifestations [1]
As there are eyes with central serous chorioretinopathy (CSC) lasting for more than 6 months but manifesting with recurrent classic characteristics, chronic CSC is not necessarily the same as diffused retinal epitheliopathy (DRPE). We applied this classification to chronic CSC in this study and evaluated only patients presenting with the manifestations of DRPE
We aim to evaluate the 24-month efficacy and safety of half-dose photodynamic therapy (PDT) for DRPE, guided by simultaneous optical coherence tomography (OCT), fluorescein angiography (FA) and indocyanine green angiography (ICGA)

Summary

Introduction

These authors contributed : Lei Li, Gezhi XuCentral serous chorioretinopathy (CSC) is defined as a serous exudative detachment of the retina, usually confined to the macula, and it exhibits a variety of visual manifestations [1]. If CSC lasts more than 3–6 months, it is considered chronic. CSC can be classified into the classic type and diffused retinal epitheliopathy (DRPE), based on the status of the retinal pigment epithelium (RPE) [2]. As there are eyes with CSC lasting for more than 6 months but manifesting with recurrent classic characteristics, chronic CSC is not necessarily the same as DRPE. For this reason, we applied this classification to chronic CSC in this study and evaluated only patients presenting with the manifestations of DRPE.

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Conclusion