Significant Visual Impairment after Short-Lasting Central Serous Chorioretinopathy

Abstract

A 37-year-old man experienced two episodes of central serous chorioretinopathy (CSCR) with the onset within a 7-month period, one in each eye. The diagnosis was made based on spectral-domain optical coherence tomography (SD-OCT), fundus autofluorescence (FAF), and fluorescein angiography. The presence of subretinal neovascularization and polypoidal choroidal vasculopathy were excluded. Each CSCR episode lasted for approximately 6 months and resolved completely after laser photocoagulation (left eye) and photodynamic therapy (right eye). In the right eye, subthreshold micropulse laser treatment and oral eplerenone were initially administered because of a verteporfin shortage, but they were not effective. Final best-corrected visual acuity was 0.8 logMAR in the left eye and “counting fingers” in the right. SD-OCT revealed significant retinal thinning in both eyes despite FAF, showing no major loss of retinal pigment epithelial cells. A significant reduction of ganglion cell complex thickness occurred in the right eye. Acute CSCR can result in significant visual impairment, even when short-lasting.

Perspectives and Update on the Global Shortage of Verteporfin (Visudyne®)

“…Despite reported efforts from the manufacturer to restore production of verteporfin, it still cannot be supplied at the required scale, a situation which is expected to last at least until the end of 2024 [1]. This results in patients being undertreated which potentially can lead to irreversible loss of vision [2][3][4]. This article aims to provide insights into the origin of the shortage, an update on the current standings, suggestions on how we can move forward, and how we could prevent similar issues in the future.…”