Prognostic factors related to photodynamic therapy for central serous chorioretinopathy.
BACKGROUND
To investigate the effects and prognostic factors related to photodynamic therapy (PDT) for central serous chorioretinopathy (CSC).


METHODS
Retrospective medical record reviewing of consecutive CSC patients (chronic or persistent typical CSC) treated with conventional PDT (full-dose verteporfin, laser (689 nm) delivery for 83 s, total light energy of 50 J/cm(2)) was performed. Besides overall anatomic and functional outcomes, the prognostic influences of various baseline factors (sex, age, duration of symptoms, presence of focal leak and pigment epithelial detachment (PED), SRF size, confluent RPE atrophy, PDT spot size), disintegrity of the junction between foveal outer and inner photoreceptor layer (OS-IS) after resolution, and post-treatment RPE changes on outcomes were evaluated.


RESULTS
Forty patients (41 eyes) were included. Anatomic success, defined as complete resolution of serous fluid on optical coherence tomography performed 4-6 weeks after PDT, was achieved in 87.8% of eyes, and visual acuity improved significantly (0.19 +/- 0.24 lines). Visual acuity had improved more than one line in 46.3% of the patients and decreased more than one line in 14.6% of patients at the 1-month follow-up visit. Prolonged symptom duration (> 9 months), PED, confluent RPE atrophy, foveal OS-IS disintegrity, and post-PDT RPE changes were associated significantly with visual loss of more than three lines and foveal atrophy. Central macular thickness was significantly reduced in patients treated with PDT compared to those treated with focal laser.


CONCLUSIONS
PDT for CSC was effective with regard to anatomic and functional outcomes. However, visual improvement may be limited in patients with prolonged symptom duration, baseline confluent RPE atrophy, foveal OS-IS disintegrity, or progression of RPE atrophy after PDT and the risk of PDT-induced foveal injury should be considered.
Department of Ophthalmology, Seoul National University College of Medicine, Seoul, Korea.
Jun Woong
JW
Moon
Hyeong Gon
HG
Yu
Tae Wan
TW
Kim
Hyung Chan
HC
Kim
Hum
H
Chung
D000328:Adult; D001284:Atrophy; D015862:Choroid Diseases / Q000175:diagnosis / Q000188:drug therapy* / Q000503:physiopathology; D005451:Fluorescein Angiography; D005500:Follow-Up Studies; D005584:Fovea Centralis / Q000473:pathology; D005654:Fundus Oculi; D006801:Humans; D008875:Middle Aged; D010778:Photochemotherapy; D017319:Photosensitizing Agents / Q000627:therapeutic use; D011166:Porphyrins / Q000627:therapeutic use; D011379:Prognosis; D012164:Retinal Diseases / Q000175:diagnosis / Q000188:drug therapy* / Q000503:physiopathology; D055211:Retinal Photoreceptor Cell Inner Segment / Q000473:pathology; D055214:Retinal Photoreceptor Cell Outer Segment / Q000473:pathology; D055213:Retinal Pigment Epithelium / Q000473:pathology; D012189:Retrospective Studies; D013997:Time Factors; D041623:Tomography, Optical Coherence; D016896:Treatment Outcome; D000077362:Verteporfin; D014792:Visual Acuity
D017319:Photosensitizing Agents; D011166:Porphyrins; D000077362:Verteporfin