Abstract
Purpose To evaluate normalized short-wavelength fundus autofluorescence (SW-FAF) imaging changes over time as a predictive parameter for the retinal pigment epithelium (RPE) function in eyes compromised by acute central serous chorioretinopathy (CSCR) after indocyanine green angiography-guided verteporfin (Visudyne®, Novartis Pharma, Basel, Switzerland) photodynamic therapy (PDT) with a half-fluence rate (25 J/cm2). Methods Quantitative data of SW-FAF grey values (SW-FAF GV) from a 350 μm (SW-350) and 1200 μm (SW-350) and 1200 t-test was calculated to explore the differences of SW-350 and SW-1200 between one month and the long-term follow-up. Results Mean differences (95% CI) in SW-FAF GV between 1 month and 7 years after half-fluence PDT were 0.07 ± 0.11 for SW-350 ([95% CI: −0.002; 0.14], p=0.06) and 0.11 ± 0.15 for SW-1200 ([95% CI: 0.01; 0.21], p=0.06) and 0.11 ± 0.15 for SW-1200 ([95% CI: 0.01; 0.21], p=0.06) and 0.11 ± 0.15 for SW-1200 ([95% CI: 0.01; 0.21], p=0.06) and 0.11 ± 0.15 for SW-1200 ([95% CI: 0.01; 0.21], Conclusion After 7 years, normalized SW-FAF GV were significantly lower in eyes with resolved acute CSCR treated with reduced-fluence PDT compared to the follow-up after 1 month without correlation to explicit pattern changes or structural damages. Half-fluence PDT remains a safe and considerable treatment option in acute CSCR.
Highlights
Acute central serous chorioretinopathy (CSCR) is a disease that primarily affects the choroidal blood circulation and is characterized by an elevation of the central neurosensory retina due to subretinal or subretinal pigment epithelium fluid (SRF; sub-RPE) accumulation leading to various visual symptoms and a reduced vision-related quality of life [1, 2]
In the light of the above, this study evaluated the longterm treatment effect of indocyanine green angiography(ICGA-) guided half-fluence photodynamic therapy (PDT) for acute CSCR on SWFAF GV as a representative of the RPE function after 7 years
Fifteen eyes were treated for acute symptomatic CSCR involving the fovea by ICGA-guided PDT within 3 months after the onset of symptoms. e location of the lesion was identified by fluorescein angiography (FA) (Figure 1(a)), and its size was determined by the existence of choroidal hyperpermeability in ICGA (Figure 1(b)) [5]
Summary
Acute central serous chorioretinopathy (CSCR) is a disease that primarily affects the choroidal blood circulation and is characterized by an elevation of the central neurosensory retina due to subretinal or subretinal pigment epithelium fluid (SRF; sub-RPE) accumulation leading to various visual symptoms and a reduced vision-related quality of life [1, 2]. Our study group previously elaborated promising results for the treatment of acute symptomatic CSCR with a reducedfluence rate (25 J/cm2) photodynamic therapy (PDT) with. Short-wavelength (SW) FAF is an accepted parameter to adequately evaluate the function of photoreceptors or RPE cells in vivo [12, 13]. Several studies on short-term results described SWFAF as a more comprehensive indicator for the course of the disease as well as treatment outcomes than BCVA or CST alone [17, 18]. Longitudinal studies are mandatory to objectify the outcome of reduced-fluence PDT over time
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