The Choroid after Half-Dose Photodynamic Therapy in Chronic Central Serous Chorioretinopathy

Abstract

Purpose: To characterize choroidal structure and vasculature after half-dose verteporfin photodynamic therapy (hd-vPDT) in eyes with chronic central serous chorioretinopathy using Enhanced Depth Imaging Optical Coherence Tomography (EDI OCT) and Optical Coherence Tomography Angiography (OCT-A). Methods: This prospective case-control study included 10 eyes. Choroid was examined before and at 1 month following hd-vPDT. We measured choroidal thickness (CT) at subfoveal area and at 750 μm nasal and temporal of fovea and thickness of Haller and choriocapillaris/Sattler layers. Whole (WA), luminal (LA) and interstitial area (IA) at EDI-OCT, and perfusion density at OCT-A were analyzed. The unaffected fellow eyes were used for comparisons. Results: Mean CT at subfoveal area and at 750 μm nasal and temporal of fovea, values of Haller and choriocapillaris/Sattler layers and those of WA, LA and IA were reduced, while PD increased at 1 month after hd-vPDT (all p < 0.001). There was a significant (p < 0.05) negative correlation (ρ = −0.658) between PD and post-treatment logMARVA. None of analyzed parameters reached values of unaffected fellow eye. Conclusion: Following hd-vPDT, choroidal thickness with both luminal and interstitial components markedly decreased, while perfusion of choriocapillaris improved.

Verteporfin Photodynamic Therapy for the Treatment of Chorioretinal Conditions: A Narrative Review

“…92 Smaller studies also support the efficacy of vPDT for CSC, including a prospective, comparative study of 10 patients with chronic CSC who had undergone a single successful treatment with half-dose vPDT; vision outcomes were significantly improved from baseline with vPDT (P=0.04), and microstructural and microcirculation changes were observed 1 month after treatment. 93 A second study retrospectively analyzed data from 32 patients (34 eyes) with CSC subgrouped by fluorescein angiography (point source leakage in FA [n=17] and diffuse dye oozing [n=16]) and reported that half-dose vPDT was effective for patients with CSC with CNV, with better results in the subgroup of patients with point source leakage, based on fewer half-dose PDT sessions (1.1 vs 1.9, respectively; P=0.006) and better final BCVA findings (logMAR, 0.1 vs 0.3; P=0.02) at year 3. 94 A different retrospective study found that vPDT, regardless of the combination of full-or half-dose verteporfin and/or full-or half-dose fluence used, significantly improved BCVA from baseline to posttreatment in patients with CSC (n=30; >1-year follow-up period; 0.5 vs 0.3, respectively; P=0.008).…”