Crossover to Half-Dose Photodynamic Therapy or Eplerenone in Chronic Central Serous Chorioretinopathy Patients

Feenstra, Helena M.A.; Dijk, Elon H. C. van; Rijssen, Thomas J. van; Tsonaka, Roula; Diederen, Roselie M.H.; Schlingemann, Reinier O.; Hoyng, Carel B.; Boon, Camiel J F

doi:10.1016/j.oret.2022.04.014

Cited by 11 publications

(8 citation statements)

References 31 publications

(41 reference statements)

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“…4,5 Beside the CSC features, complete resolution of SRF represents the primary treatment outcome in both clinical practice and clinical trials. [6][7][8][9] After resolution of SRF, cases are categorized in the "resolved" stage. In detail, the term chronic "resolved" CSC is usually used to define individuals without SRF and with history/signs of previous accumulation of fluid in the subretinal space.…”

Section: Discussionmentioning

confidence: 99%

Prevalence and Morphologic Biomarkers of Metamorphopsia in Eyes With “Resolved” Chronic Central Serous Chorioretinopathy

Borrelli

Barresi

Battista

et al. 2023

Retina

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Purpose: To assess relationships between demographics, clinical characteristics, and optical coherence tomography characteristics with persistence of metamorphopsia after resolution of subretinal fluid in eyes with chronic central serous chorioretinopathy. Methods: One-hundred participants with “resolved” (absence of subretinal fluid) chronic central serous chorioretinopathy were retrospectively analyzed. Patients underwent a complete ophthalmologic evaluation, including assessment of the presence of metamorphopsia. At the study visit, optical coherence tomography scans were reviewed for qualitative and quantitative features. Results: Sixty-six of 100 patients (66.0%) complained of metamorphopsia. Both the foveal and parafoveal ganglion cell complex thicknesses were thinner in central serous chorioretinopathy eyes with metamorphopsia (35.1 ± 10.6 µm and 82.0 ± 18.1 µm vs. 40.7 ± 11.8 µm and 93.1 ± 13.5 µm, P = 0.030 and P < 0.0001). In the foveal region, the outer plexiform layer and outer nuclear layer thicknesses were thinner in patients with metamorphopsia (24.6 ± 8.5 µm and 63.1 ± 20.9 µm vs. 29.1 ± 8.7 and 76.2 ± 18.2 µm, P = 0.016 and P = 0.005). The ellipsoid zone band was more frequently discontinued in eyes with metamorphopsia (56.1% vs. 35.3%, P = 0.039). Multivariate stepwise linear regression analysis demonstrated that the strongest associations with the presence of metamorphopsia were with parafoveal ganglion cell complex thickness (P = 0.004), foveal outer nuclear layer thickness (P = 0.010), and number of previous recurrences of subretinal fluid accumulation (P = 0.017). The time interval from the last subretinal fluid resolution was not associated with the presence of metamorphopsia. Conclusion: In “resolved” central serous chorioretinopathy, clinical aspects (i.e., number of previous recurrences) and structural changes (i.e., ganglion cell complex and outer nuclear layer thinning) are associated with metamorphopsia after subretinal fluid resolution.

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Section: Discussionmentioning

confidence: 99%

Prevalence and Morphologic Biomarkers of Metamorphopsia in Eyes With “Resolved” Chronic Central Serous Chorioretinopathy

Borrelli

Barresi

Battista

et al. 2023

Retina

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“…28 Crossover to PDT treatment after the failure of eplerenone treatment led to complete resolution of SRF in a majority of patients after 3 months, an effect not seen in PDT to eplerenone crossover, further supporting PDT's superiority for treating chronic CSCR. 29 Additional iterations of PDT beyond dose and fluence adjustments include varying the associated imaging modality used. Imaging is employed in PDT to determine areas of hyperpermeability and leakage that can be focally targeted with laser spots.…”

Section: Photodynamic Therapymentioning

confidence: 99%

Update on the Management of Central Serous Chorioretinopathy

Bordbar,

Skrehot,

Weng

2023

International Ophthalmology Clinics

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“…It is important to ascertain the correct diagnosis, using multimodal imaging (MMI), as a correct diagnosis ensures the choice of a fitting treatment, when available. For example, if the fluid is caused by a disease from the pachychoroid disease spectrum, such as CSC or PPS, photodynamic therapy may be the treatment of choice 10–16 …”

Section: Introductionmentioning

confidence: 99%

“…For example, if the fluid is caused by a disease from the pachychoroid disease spectrum, such as CSC or PPS, photodynamic therapy may be the treatment of choice. [10][11][12][13][14][15][16] However, cases may be encountered where IRF and/or SRF can be seen around the optic disc, but in whom hardly any or no abnormalities on fluorescein angiography (FA) or ICGA are observed. In these cases, it may not always be easy to establish an exact diagnosis, and as a result, it may be difficult to prescribe the correct treatment.…”

Section: Introductionmentioning

confidence: 99%

NOn-Pachychoroid PEripapillary Schisis (NOPPES) of the Retina: A New Phenotype and its Differential Diagnosis

Sirks,

van Dijk,

Pauleikhoff

et al. 2023

Asia-Pacific Journal of Ophthalmology

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Purpose: The presence of peripapillary intraretinal fluid (IRF) has a broad differential diagnosis, including several types of neovascular and pachychoroid-related diseases. However, the clinician may encounter cases without signs of neovascular or pachychoroid disease, or any other previously described diagnosis. For these patients, we propose the term NOn-Pachychoroid PEripapillary Schisis (NOPPES) of the retina, and we discuss the differential diagnosis. Design: A retrospective chart study set in a tertiary referral center for retinal diseases in Amsterdam, the Netherlands. Methods: Using multimodal imaging, cases suspected of peripapillary pachychoroid syndrome were reviewed. Cases without signs of neovascular or pachychoroid disease were included in this study. These cases were discussed in a group of senior retinal specialists to establish a diagnosis, and if there was no evidence for any previously described diagnostic entity, these cases were categorized as NOPPES. Results: Four cases of NOPPES were identified, 3 female patients and 1 male patient, aged between 58 and 75 years. Two patients were myopic, and 1 patient had a mild hyperopia. Three out of 4 cases showed unilateral peripapillary IRF, and 1 case had bilateral IRF. No improvement was seen after intravitreal bevacizumab or aflibercept, nepafenac eye drops, oral acetazolamide, vitrectomy with internal limiting membrane peeling, or surgery for carotid stenosis. One case showed a reduction in IRF after starting prednisolone eye drops. Conclusions: We describe NOPPES, a new form of peripapillary schisis-like IRF. NOPPES seems relatively therapy-resistant. More research is needed to delineate the clinical spectrum of NOPPES and its pathogenesis and treatment.

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Crossover to Half-Dose Photodynamic Therapy or Eplerenone in Chronic Central Serous Chorioretinopathy Patients

Cited by 11 publications

References 31 publications

Prevalence and Morphologic Biomarkers of Metamorphopsia in Eyes With “Resolved” Chronic Central Serous Chorioretinopathy

Prevalence and Morphologic Biomarkers of Metamorphopsia in Eyes With “Resolved” Chronic Central Serous Chorioretinopathy

Update on the Management of Central Serous Chorioretinopathy

NOn-Pachychoroid PEripapillary Schisis (NOPPES) of the Retina: A New Phenotype and its Differential Diagnosis

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