Abstract
To evaluate choroidal volume and thickness changes after photodynamic therapy (PDT) for chronic central serous chorioretinopathy (CSC). Chronic CSC eyes with a history of PDT were selected. Average choroidal volume, average choroidal thickness, the maximum and minimum choroidal thickness of the macula irradiated area and peripheral non-irradiated areas before and after one and three months of treatment were examined. A total of 14 patients with chronic CSC and 9 controls without any eye pathology were enrolled. The mean choroidal volume in CSC before and, and after one and three months of treatment were 2.36 (standard deviation: 0.70), 1.90 (0.69), 1.86 (0.66) mm3 for the central area, 1.25 (0.38), 1.14 (0.35), 1.13 (0.34) mm3 for superior nasal area, 1.47 (0.41), 1.28 (0.43), 1.26 (0.43) mm3 for superior temporal area, 1.07 (0.49), 0.95 (0.38), 0.93 (0.35) mm3 for inferior nasal area, 1.17 (0.38), 1.04 (0.32), 1.03 (0.33) mm3 for inferior temporal area. This study revealed the choroidal volume changes in a short period after PDT and a decrease in unirradiated choroidal volume was also shown after the treatment. The algorithm provided on the ARI Network enables to evaluate the choroidal changes quantitatively and qualitatively.
Highlights
After the treatment of age-related macular degeneration with photodynamic therapy (TAP) study and the verteporfin in photodynamic therapy (VIP) study for age-related macular degeneration, an expanded indication of photodynamic therapy (PDT) has allowed to treat central serous chorioretinopathy (CSC) [1,2]
The purpose of this present study is to evaluate choroidal morphologic changes both in irradiated and peripheral non-irradiated areas treated with PDT in CSC
Inter-test repeatability was very high, with an intraclass correlation coefficient (ICC) of 0.961 (95% confidence interval (CI), 0.946–0.971) for choroidal volume, 0.955 for average choroidal thickness, 0.881 for maximum choroidal thickness, and 0.944
Summary
After the treatment of age-related macular degeneration with photodynamic therapy (TAP) study and the verteporfin in photodynamic therapy (VIP) study for age-related macular degeneration, an expanded indication of photodynamic therapy (PDT) has allowed to treat central serous chorioretinopathy (CSC) [1,2]. Standard PDT with verteporfin is an effective and safe treatment for chronic CSC with a significant improvement in the 4-year post-op period, both anatomically and visually [3]. Choriocapillaris ischemia, secondary choroidal neovascularization, transient impairment in retinal function, and retinal pigment epithelium (RPE) atrophy are common side effects of PDT treatment [4,5,6]. To minimize the side effects, a reduced dose, fluence, and exposure time of PDT have been evaluated in CSC treatment. Reduced fluence PDT is effective for symptomatic subfoveal serous pigment epithelial detachments with hyper fluorescence on late-phase indocyanine green angiography (ICGA) [7]. Half dose or fluence PDT is the preferable standard treatment for chronic CSC [10]
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