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Photodynamic therapy in the treatment of CSCR
Author(s) -
RUIZ MORENO JM
Publication year - 2012
Publication title -
acta ophthalmologica
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.534
H-Index - 87
eISSN - 1755-3768
pISSN - 1755-375X
DOI - 10.1111/j.1755-3768.2012.3214.x
Subject(s) - photodynamic therapy , medicine , ophthalmology , visual acuity , optical coherence tomography , serous fluid , chemistry , organic chemistry
Abstract Purpose To evaluate the efficacy of photodynamic therapy (PDT) to treat chronic central serous chorioretinopathy (CSC) and changes in neural retina (NR) thickness and best corrected visual acuity (BCVA) induced by PDT. Methods Non randomized, multicentric, interventional case series. 82 eyes of 72 patients with chronic CSC were treated by conventional PDT. LogMAR BCVA and central foveal thickness (CFT) measured by optical coherence tomography (OCT) before and after PDT, number of PDT treatments and complications were considered as outcome indicators. In 26 eyes LogMAR BCVA and OCT were evaluated before treatment and one year after PDT. 24 eyes from 24 patients with non chronic, non PDT treated forms of CSC were evaluated as a control group. Results BCVA changed from 0.53 before PDT to 0.48 at 6 months (p=0.007). Subretinal fluid disappeared in all the cases. CFT decreased from 325 µm, to 229 µm one month after PDT; to 206 µm at three months; and to 202µm at six months (p<0.0001 in the three cases). No cases developed severe visual loss or complications derived from PDT. In subgroup studied at one year NR CFT before PDT was 181.4±42.6 μ vs. 149.0±30.6 μm one year after treatment (p=0.004). NR CFT in the untreated eyes was 204.6±30.7 μ vs. 192.5±26.4 μ after self resolution (p=0.03). Basal NR thickness was not statistically significant different between both groups (P = 0.31); this difference became significant at the end of the follow‐up (P<0.01). Conclusion PDT may be useful in chronic CSC improving BCVA and reducing subretinal fluid and CFT. The use of PDT in chronic CSC induces NR thickness thinning. This change is not correlated with a decrease in BCVA. Randomized studies with longer follow‐up are needed to asses the real role of this treatment in chronic CSC.