Photodynamic Therapy in the Treatment of Persistent Central Serous Chorioretinopathy: a Two-Year Follow-Up

Abstract

Background: The aim of this study was to assess during a follow-up period of two years the efficacy and safety of photodynamic therapy (PDT) in central serous chorioretinopathy (CSC) showing no spontaneous resolution four months after the onset of the symptoms.

Patients and Methods: We present a prospective interventional non-comparative case series. The diagnosis of CSC was confirmed by fluorescein angiography (FA), and optical coherence tomography (OCT) in 46 eyes of 42 consecutive patients. PDT was performed according to the protocol used for treating choroidal neovascularization in age-related macular degeneration. The primary end point was to assess the anatomic re-attachment of the retina. The secondary end point was to record the visual function. A paired t-test and a linear regression and correlation test were used for the statistics.

Results: The leakage in FA and the detachment of the neurosensory retina in OCT were no longer present in 42 eyes six weeks after PDT and in the remaining four eyes three months after PDT. At the end of the follow-up, the best-corrected visual acuity measured with an ETDRS chart improved in 36 eyes, and remained stable in 10 eyes (mean improvement, 10.2 letters; p < 0.001). Two cases of recurrence were diagnosed. No treatment-related complications were noticed.

Conclusions: PDT could be an effective and durable option for treating patients with persistent CSC.

Zusammenfassung

Hintergrund: Die Wirksamkeit und die Sicherheit der photodynamischen Therapie (PDT) bei der Behandlung von Retinitis centralis serosa (RCS) ohne spontane Heilung 4 Monate nach Beginn der Symptome wurden untersucht.

Patienten und Methoden: Es handelt sich um eine prospektive interventionelle nicht komparative Studie mit einem 2-jährigen Verlauf. Die Diagnose einer RCS wurde in 46 Augen von 42 konsekutiven Patienten mittels Fluoreszenzangiografie (FA) und optischer Kohärenztomografie (OCT) bestätigt. Die PDT wurde mit dem gleichen Protokoll wie für die Behandlung von choroidalen Neovaskularisationen bei altersabhängiger Makuladegeneration eingesetzt. Das primäre Beurteilungskriterium war die anatomische Wiederanlegung der Netzhaut. Das sekundäre Beurteilungskriterium war die Messung des Visus. Ein gepaarter t-Test und eine lineare Regression und Korrelation wurden für die Statistik angewandt.

Ergebnisse: Die RCS verheilte in 42 Augen 6 Wochen nach der PDT und in den letzten 4 Augen 3 Monate nach der PDT. Am Ende des Verlaufs verbesserte sich der korrigierte und mit ETDRS-Buchstaben gemessene Visus in 36 Augen und blieb in 10 Augen stabil (durchschnittliche Verbesserung von 10,2 Buchstaben; p < 0,001). 2 Rezidiven wurden diagnostiziert. Keine behandlungsbedingten Komplikationen wurden festgestellt.

Schlussfolgerungen: Die PDT könnte eine wirksame und sichere Option sein, um Patienten mit RCS zu behandeln.

Key words

photodynamic therapy - central serous chorioretinopathy

Schlüsselwörter

photodynamische Therapie - Retinitis centralis serosa

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