Severe choroidal ischemia following photodynamic therapy for pigment epithelial detachment and chronic central serous chorioretinopathy.
BACKGROUND
Photodynamic therapy (PDT) has proven beneficial in the treatment of central serous chorioretinopathy (CSC).


METHODS
Two patients with serous pigment epithelial detachments (PEDs) and one patient with chronic CSC developed an abrupt visual loss caused by severe choroidal ischemia following PDT. Serous PEDs in the two patients were regarded as a latent variant of CSC. PDT was performed in accordance with the Treatment of Age-Related Macular Degeneration with Photodynamic Therapy guidelines.


METHODS
Although following PDT, PEDs and serous sensory retinal detachments resolved in all patients, the laser-treated areas of the patients revealed severe choroidal ischemia and their visual acuity decreased. Only in case 1 did visual acuity recover to the pretreatment level 2 months after treatment. In case 2, visual acuity was still reduced 7 months after treatment. In case 3, secondary choroidal neovascularization developed in the treatment area 1 month after treatment.


CONCLUSIONS
In the CSC variant associated with PED only or in chronic CSC, PDT performed by the standard procedure can increase the risk of severe choroidal ischemia. Further studies are needed to find safe and optimal PDT parameters.
Lee
Phil Young
PY
Seoul Veterans Hospital, Seoul, Korea.
Kim
Ki Seok
KS
Saevit Eye Hospital, Seoul, Korea.
Lee
Won Ki
WK
Department of Ophthalmology and Visual Science, Kangnam St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea. wklee@catholic.ac.kr.|Department of Ophthalmology and Visual Science, Kangnam St. Mary's Hospital, College of Medicine, The Catholic University of Korea, #505 Banpo-Dong, Seocho-Gu, Seoul, 137-701, Korea. wklee@catholic.ac.kr.
D000328:Adult; D000368:Aged; D002199:Capillary Permeability; D002829:Choroid / Q000098:blood supply*; D002908:Chronic Disease; D004396:Coloring Agents; D005260:Female; D005451:Fluorescein Angiography; D006801:Humans; D007208:Indocyanine Green; D007511:Ischemia / Q000175:diagnosis / Q000209:etiology*; D008297:Male; D010778:Photochemotherapy / Q000009:adverse effects*; D012163:Retinal Detachment / Q000175:diagnosis / Q000188:drug therapy*; D055213:Retinal Pigment Epithelium / Q000187:drug effects* / Q000473:pathology; D012307:Risk Factors; D044967:Serum; D041623:Tomography, Optical Coherence; D014786:Vision Disorders / Q000209:etiology; D014792:Visual Acuity
D004396:Coloring Agents; D007208:Indocyanine Green