Early vessel occlusion and recanalization after photodynamic therapy in central serous chorioretinopathy by OCT angiography

Fernández‐Vigo, José Ignacio; Moreno-Morillo, Francisco Javier; Burgos-Blasco, Bárbara; López-Guajardo, Lorenzo; Donate-López, J.

doi:10.1177/11206721211027060

Cited by 7 publications

(13 citation statements)

References 4 publications

(3 reference statements)

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“…Interestingly, in the present study, there was a significant increase in CCT as well as CRT 3 days after PDT in the PAEM+ group, but not in the PAEM- group. A recent report using OCT angiography showed vascular occlusion of the choriocapillaris corresponding to the treated area at 3 days after PDT and recanalization of the choroidal capillary plate at 6 days 34 . The fact that temporary occlusion of choriocapillaris occur early after PDT may be considered supportive of our results.…”

Section: Discussionmentioning

confidence: 91%

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

Honda

Kohno

Yamamoto

et al. 2022

Sci Rep

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The purpose of this study was to investigate the occurrence rate and predictors of photodynamic therapy (PDT) induced acute exudative maculopathy (PAEM). This retrospective study included 39 eyes of 39 patients (32 males and 7 females), who were treated with initial PDT. PAEM was defined as an increase in central retinal thickness (CRT) of 15% or more measured by OCT on day 3 after PDT compared with baseline. Sixteen of 39 eyes (41%) were classified in the PAEM+ group. CRT and central choroidal thickness (CCT) were significantly increased at 3 days in the PAEM+ group and significantly decreased at 1 month after PDT in the PAEM- group. In a multiple comparison, neovascular age-related macular degeneration (nAMD) had a significantly higher incidence of PAEM compared to polypoidal choroidal vasculopathy (PCV) and central serous chorioretinopathy (CSC). The incidence of PAEM was lower in PCV and CSC, and higher in nAMD. BCVA at 1 month was significantly worse in the PAEM group, which may be related to visual prognosis after PDT. Since both CRT and CCT decrease at 1 month, the detection of PAEM needs to be assessed a few days after PDT.

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Section: Discussionmentioning

confidence: 91%

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

Honda

Kohno

Yamamoto

et al. 2022

Sci Rep

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“…29 Following treatment of PAEM, histopathologic analysis and optical coherence tomographic angiography (OCT-A) provide evidence of recanalization of blood vessels following PDT that is complete between one week and one month. 26,36 This may be one mechanism by which resolution of subretinal fluid resolves with observation alone in some reports.…”

Section: Pdt-induced Acute Exudative Maculopathymentioning

confidence: 99%

“…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. These include age over 65 years, PCV, spot size >3.5 mm, pre-treatment best corrected visual acuity (BCVA) 20/40 or better, first time treatment and reduced-fluence PDT.…”

Section: Prevalence and Disease Characteristicsmentioning

confidence: 99%

“…[43][44][45] Lastly, observation has been shown to be an effective management strategy particularly specific to PAEM in the setting of CSCR. 30,36 This strategy has not been reported in other conditions, though given the evidence of vascular recanalization following PDT in one to four weeks and a recovery period that is similar between PAEM in CSCR and the other described conditions, 26,37 it is unclear whether adding treatment with anti-VEGF or corticosteroids provides a true benefit over observation alone.…”

Section: Management Strategiesmentioning

confidence: 99%

“…37 Recanalization of these flow voids is proposed to occur by one month following treatment and may be correlated to resolution of subretinal fluid. 26,36,37 In a fluorescence pharmacokinetics study by Debefve et al, aspirin was co-administered with verteporfin in chicken embryos to assess the effects of cyclo-oxygenase inhibition on vascular permeability following PDT. Enhancement of vascular leakage was found in this setting, representing another possible risk factor in patients taking aspirin or similar medications.…”

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confidence: 99%

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

Sumnicht¹,

Chalam²,

Sierpina³

2022

OPTH

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Photodynamic therapy (PDT) has a niche role in treating various choroidal pathologies. PDT-induced acute exudative maculopathy (PAEM) is an uncommon complication of PDT that results in exudative retinal detachment and mild to severe decrease in vision. Successful management strategies include observation, local or systemic corticosteroids, and intravitreal anti-vascular endothelial growth factor (anti-VEGF) injections. Most cases return to visual acuity near baseline. This review summarizes what is known about PAEM to date including etiology, prevalence, management strategies, and outcomes. We conclude that management of PAEM must take into consideration various patient-specific factors. Treatment with corticosteroids or anti-VEGF agents may expedite time to recovery, though lack of randomized controlled trials preclude firm conclusions regarding a standardized approach to managing this complication of PDT.

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Laser Treatment of Central Serous Chorioretinopathy – An Update

Gawecki,

Pytrus,

Swiech

et al. 2024

Klin Monbl Augenheilkd

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Laser treatment has been a mainstay for management of central serous chorioretinopathy for a few decades. Different types of lasers have been used and non-damaging retinal laser is the most recent option. The aim of this review is to provide an update on this form of treatment, based on the research published during last 5 years, in comparison with earlier studies published. A MEDLINE database search was performed with a combination of the following terms: central serous chorioretinopathy and laser photocoagulation or subthreshold laser or subthreshold micropulse laser or nanosecond laser or microsecond laser or end-point management or photodynamic therapy. Results were analyzed separately for each modality of laser treatment. Reports published in recent years confirm findings of previous research and do not distinguish treatments of this clinical entity. Among all analyzed laser options, photodynamic therapy provides the fastest and most prominent morphological improvements, including subretinal fluid resorption and reduction of choroidal thickness. This modality is also associated with fewer recurrences than with other treatments. Subthreshold micropulse laser allows the physician to maintain and, in selected cases, improve the patientʼs vision. Conventional photocoagulation is still effective, especially with the introduction of navigated laser systems. Despite the availability of variable laser treatment options, long-term functional improvements in chronic cases are minor for each modality. Long-lasting central serous chorioretinopathy cases with significantly altered retinal morphology do not usually present with functional improvement, despite satisfactory morphological outcomes. Early initiation of treatment has the potential to prevent visual loss and to improve the patientʼs quality of life.

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Early vessel occlusion and recanalization after photodynamic therapy in central serous chorioretinopathy by OCT angiography

Cited by 7 publications

References 4 publications

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

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

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

Laser Treatment of Central Serous Chorioretinopathy – An Update

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