Acute Exudative Maculopathy and Bacillary Layer Detachment in Patients With Central Serous Chorioretinopathy After Photodynamic Therapy

Abstract

Photodynamic therapy–induced acute exudative maculopathy was frequent in chronic central serous chorioretinopathy. However, a self-resolving evolution and favorable prognosis were observed in most cases. There was no association between photodynamic therapy–induced acute exudative maculopathy and age, sex, or choroidal neovascularization but was associated with worse baseline visual acuity and choriocapillaris vessel occlusion.

Early anatomical changes and association with photodynamic therapy induced acute exudative maculopathy in patients with macular diseases

“…Our study also resulted that BCVA had decreased in the PAEM+ group 1 month after PDT, but the long-term effect has been still unknown. Fernandez-Vigo et al reported that PAEM did not affect the mean BCVA gain at 3 months after PDT in chronic CSC, so further investigation is warranted 26 .…”

“…Some reports have shown that PAEM is more likely to occur in CNV, followed by PCV, and rarely in chronic CSC 24 , 27 , 28 . Recently, Fernandez-Vigo et al 26 reported that in 92 eyes with CSC PAEM was observed 28 eyes (30.4%) with the criteria that define PAEM as an increase of 50 µm or more in the SRF height 3 days after PDT. While this percentage seemed to be higher than in other previous studies, including ours as CSC, that study was included the patients with CNV, which may be the reason for the higher percentage despite in CSC.…”

“…Patients were evaluated by slit-lamp examination, fundus color image and OCT at baseline, 3 days and 1 month after PDT. Though PAEM is defined as a subretinal exudation with or without vision loss occurring within a few days after PDT, there are currently no clear criteria 23 , 24 , 26 . We have clearly defined PAEM to allow detection of minor changes after PDT: an increase in central retinal thickness (CRT) of 15% or more measured by OCT on day 3 after PDT compared with baseline.…”

“…Recently, PDT-induced acute exudative maculopathy (PAEM), which develops a few days after PDT, has been reported and has attracted much attention 23 – 26 . PAEM is thought to be a condition of serous retinal detachment due to an acute fibrinous inflammatory process, which may cause vision loss in the early stage of treatment.…”

Photodynamic Therapy-Induced Acute Exudative Maculopathy (PAEM): Prevalence, Impact and Management Strategies

“…PAEM occurs in an estimated 1.4-30.4% of patients treated with PDT. 33,34,37 It has been reported to occur in the setting of chronic CSCR, choroidal hemangioma, retinal capillary hemangioma, CNVM, nAMD, and PCV with the highest incidence reported in CSCR (30.4%) followed by PCV (8.45%) and nAMD (6.67%). 17,[30][31][32][33][34]36 In a 2020 report, Manayath et al described the risk factors for PAEM in a large cohort of 177 PDT treatments in 155 eyes.…”