Abstract
We appreciate the interest and comments of Dr. Azad and associates. We agree that it is difficult to differentiate between choroidal neovascularization that occurs in patients with chronic recurrent central serous and the diffuse pigment epithelium decomposition and hyperpermeability of the choriocapillaries without choroidal neovascularization. ICG is an excellent way to determine leakage sites and may better delineate choroidal neovascularization in patients with central serous. 1 Guyer D.R. Yannuzzi L.A. Slakter J.S. Sorenson J.A. Hope-Ross M. Orlock D.R. Digital indocyanine-green videoangiography of occult choroidal neovascularization. Ophthalmology. 1994; 101: 1727-1735 Crossref PubMed Scopus (154) Google Scholar For our study, we defined chronic recurrent central serous as the condition that occurs with chronic recurrent leaks and is associated with retinal pigment epithelium atrophy, usually occurring in older patients. We did examine our patients looking for evidence of CNV but could not prove conclusively that it was present. The incidence of CNV associated with chronic central serous is low (4%-8%). 2 Bandello F. Virgil G. Lanzetta P. et al. ICG angiography and retinal pigment epithelia decompensation. J Fr Ophthalmol. 2001; 24: 448-451 Google Scholar , 3 Loo R.H. Scott I.u. Flynn Jr, H.W. et al. Factors associated with reduced visual acuity during long-term follow-up of patients with idiopathic central serous chorioretinopathy. Retina. 2002; 22: 19-24 Crossref PubMed Scopus (293) Google Scholar Our patients required only one PDT treatment and had no recurrence of their leak. This is unusual in our experience with PDT-treated patients for choroidal neovascular membrane. 4 Treatment of Age-Related Macular Degeneration with Photodynamic Therapy (TAP) Study GroupPhotodynamic therapy of subfoveal choroidal neovascularization in age-related macular degeneration with verteporfin One-year results of 2 randomized clinical trials—TAP report 1. Arch Ophthalmol. 1999; 108: 1329-1345 Google Scholar None of our cases demonstrated subretinal hemorrhage, which is commonly associated with choroidal neovascular membranes. 5 Chan W. Lam D.S.C. Lai T.Y.Y. et al. Treatment of choroidal neovascularization in central serous chorioretinopathy by photodynamic therapy with verteporfin. Am J Ophthalmol. 2003; 136: 836-845 Abstract Full Text Full Text PDF PubMed Scopus (61) Google Scholar
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