title: Efficacy of photodynamic therapy in steroid-associated chronic central serous chorioretinopathy: a case-control study.
abstract: OBJECTIVE
  To investigate whether patients who developed chronic central serous chorioretinopathy (cCSC) in association with corticosteroid treatment respond differently to photodynamic therapy (PDT) as compared to patients who have not used corticosteroids.
  
  
  METHODS
  Clinical evaluation included visual acuity (VA), fundoscopy, optical coherence tomography (OCT), fluorescein and indocyanine green angiography. The main outcome measure was a complete resolution of subretinal fluid (SRF) on OCT after PDT.
  
  
  RESULTS
  One hundred and twenty-three eyes (117 patients), including 35 steroid-associated cases (29%), who received PDT treatment with reduced settings for active cCSC were included. Complete resolution of SRF on OCT was seen in 69% of the steroid-associated cases and in 50% of the controls after PDT treatment (p = 0.062). At the final follow-up moment, 74% of the cases had a complete resolution of SRF compared to 60% in the control group (p = 0.142). The VA at the first visit after therapy showed an increase in both groups (mean VA before treatment; cases: 69 ± 14 Early Treatment Diabetic Retinopathy Study (ETDRS) letters, controls: 74 ± 13 ETDRS letters, mean VA first visit after treatment; cases: 76 ± 13 ETDRS letters, controls: 75 ± 13 ETDRS letters). No significant differences were seen in response to PDT between the patients who continued corticosteroid treatment and those who ceased the use of corticosteroids.
  
  
  CONCLUSIONS
  Photodynamic therapy appears to be equally effective in patients suffering from steroid-associated cCSC as compared to patients with cCSC who do not use corticosteroids. Continuation of corticosteroids at the time of PDT treatment does not seem to adversely affect PDT response.
authors.affiliation: Department of Ophthalmology, Radboud University Medical Center, Nijmegen, the Netherlands.
authors.forename: Myrte B
authors.initials: MB
authors.lastname: Breukink
authors.affiliation: Department of Ophthalmology, Leiden University Medical Center, Leiden, the Netherlands.
authors.forename: Danial
authors.initials: D
authors.lastname: Mohabati
authors.affiliation: Department of Ophthalmology, Leiden University Medical Center, Leiden, the Netherlands.
authors.forename: Elon H C
authors.initials: EH
authors.lastname: van Dijk
authors.affiliation: Department of Ophthalmology, Radboud University Medical Center, Nijmegen, the Netherlands.
authors.forename: Anneke I
authors.initials: AI
authors.lastname: den Hollander
authors.affiliation: Department of Ophthalmology, Radboud University Medical Center, Nijmegen, the Netherlands.
authors.forename: Eiko K
authors.initials: EK
authors.lastname: de Jong
authors.affiliation: Department of Ophthalmology, Leiden University Medical Center, Leiden, the Netherlands.
authors.forename: Greet
authors.initials: G
authors.lastname: Dijkman
authors.affiliation: Department of Ophthalmology, Radboud University Medical Center, Nijmegen, the Netherlands.
authors.forename: Jan E E
authors.initials: JE
authors.lastname: Keunen
authors.affiliation: Department of Ophthalmology, Radboud University Medical Center, Nijmegen, the Netherlands.
authors.forename: Carel B
authors.initials: CB
authors.lastname: Hoyng
authors.affiliation: Department of Ophthalmology, Leiden University Medical Center, Leiden, the Netherlands.
authors.forename: Camiel J F
authors.initials: CJ
authors.lastname: Boon
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D016022:Case-Control Studies; D056833:Central Serous Chorioretinopathy / Q000139:chemically induced / Q000188:drug therapy* / Q000503:physiopathology; D002908:Chronic Disease; D005260:Female; D005451:Fluorescein Angiography; D005938:Glucocorticoids / Q000009:adverse effects*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010778:Photochemotherapy; D017319:Photosensitizing Agents / Q000627:therapeutic use; D011166:Porphyrins / Q000627:therapeutic use; D012189:Retrospective Studies; D058471:Subretinal Fluid; D041623:Tomography, Optical Coherence; D000077362:Verteporfin; D014792:Visual Acuity / Q000502:physiology
chemical_list: D005938:Glucocorticoids; D017319:Photosensitizing Agents; D011166:Porphyrins; D000077362:Verteporfin
keywords: central serous chorioretinopathy; chronic central serous chorioretinopathy; glucocorticosteroids; half-dose PDT; half-time PDT; photodynamic therapy