Foveal Function and Thickness After Verteporfin Photodynamic Therapy in Central Serous Chorioretinopathy With Hyperautofluorescent Subretinal Deposits

Abstract

Eyes with foveal detachment and subretinal deposits that underwent PDT for CSC did not recover to the functional and structural level of the asymptomatic fellow eyes, irrespective of the number of episodes of CSC. The study indicates that subretinal deposits are associated with irreversible foveal damage in CSC.

Profile of verteporfin and its potential for the treatment of central serous chorioretinopathy

“…The mean retinal sensitivity of 7.2 dB in the area of serous retinal detachment increased significantly to 15.4 dB 12 months after half dose PDT. This post-treatment increase in microperimetry sensitivity is similar to that found by Pryds et al41 Compared to previous studies evaluating retinal microperimetry after PDT for CSCR, Fujita et al45 provided additional data regarding retinal structural details. Fujita et al45 observed an improvement in the status of the ELM, IS/OS, and COST lines following therapy.…”

“…Pryds et al41 attempted to shed further light on the clinical significance of hyperautofluorescent subretinal deposits in chronic CSCR noted by Shinojima et al40 and several prior authors 42,43. Using microperimetry to assess retinal function, the investigators used PDT in 21 patients with CSCR of at least 4 months duration with serous retinal detachments, autofluorescent subretinal deposits, and late FA leakage.…”

Half-Time Photodynamic Therapy for Central Serous Chorioretinopathy

“…However, there were no images from ICGA for the case of recurrence in this study; therefore, it could not be ascertained whether ICGA could have detected a larger area of abnormal choriocapillaris at initial presentation or whether a larger treatment area could have prevented the recurrence in this case. Pryds et al 26 also reported favorable outcomes regarding foveal thickness and foveal sensitivity 4 months after FA-guided PDT. Similarly, Valmaggia et al 27 documented the effectiveness of FA-guided treatment in persistent CSC in terms of BCVA and reattachment of the neurosensory retina documented by OCT, although two patients experienced recurrence during follow-up.…”

“…Although the PDT treatment was successful with complete resolution of SRF, those patients with a longer duration of symptoms still had poorer vision after PDT. Pryds et al 26 showed a significant amount of deficit in foveal sensitivity of eyes with either initial or recurrent episodes of CSC compared with that of the unaffected fellow eyes 4 months after PDT. Chappelow and Marmor 29 demonstrated increased but still subnormal multifocal electroretinographic response after recovery from CSC.…”

Retinal sensitivity assessed by microperimetry and corresponding retinal structure and thickness in resolved central serous chorioretinopathy

“…13,14 The usefulness of microperimetry (MP) in evaluating retinal sensitivity (RS) and central retinal field function is well known in resolved CSC. [15][16][17][18][19][20][21][22][23][24] Although most MP evaluations of RS in patients after CSC resolution have used the MP-1 Microperimeter (Nidek Technologies, Padova, Italy), [15][16][17][18][19][20][21][22][23][24] this microperimeter presents MP values on a confocal scanning laser ophthalmoscope (cSLO) image without producing an optical coherence tomography (OCT) image. Therefore, direct comparisons between RS and retinal changes at a corresponding point are not possible.…”