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Nobuhiro Terao, Tetsuya Yamagishi, Yuji Yamamoto, Hideki Koizumi, Chie Sotozono; Changes in axial length and subfoveal choroidal thickness after photodynamic therapy for central serous chorioretinopathy. Invest. Ophthalmol. Vis. Sci. 2017;58(8):5928.
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© ARVO (1962-2015); The Authors (2016-present)
To investigate the changes in axial length (AL) and subfoveal choroidal thickness (SCT) after half-dose verteporfin photodynamic therapy (PDT) for central serous chorioretinopathy (CSC).
This retrospective, observational case series involved 48 eyes (24 CSC eyes and 24 unaffected fellow eyes) of 24 patients (4 females and 20 males; mean age: 55.0+/-10.5 years) with unilateral CSC which showed the disappearance of serous retinal detachment after PDT. CSC was diagnosed using optical coherence tomography (OCT), fluorescein angiography, and indocyanine green angiography. The primary outcomes were the changes before and at 3-months after PDT in AL, SCT and spherical equivalent (SE) in the treated eyes and those in the unaffected fellow eyes. SCT was measured on enhanced depth imaging-OCT (EDI-OCT) images and AL was measured via partial coherence interferometry (IOLMaster; Carl Zeiss Meditec).
The mean AL in the treated eyes increased significantly from 23.85+/-1.11mm at baseline to 24.01+/-1.13mm (P<0.001) at 3-months after PDT, whereas that in the unaffected eyes changed from 24.06+/-1.16mm at baseline to 24.05+/-1.16mm at 3-months after PDT (P=0.118). The mean SCT in the treated eyes decreased significantly from 462+/-70μm at baseline to 391+/-90μm (P<0.001) at 3-months after PDT, whereas that in the unaffected eyes changed from 363+/-95μm at baseline to 366+/-96μm (P=0.479). In the treated eyes, significant elongation of AL (mean change: 0.16+/-0.13mm=160μm; P<0.001; 95%CI: 0.11-0.21) and significant reduction of SCT (mean change: 71+/-44μm; P<0.001; 95%CI: 52-90) were observed at 3-months after PDT. No difference was found at baseline and at 3-months after PDT in regard to SE in both the treated eyes and the unaffected fellow eyes.
A distinct difference was found between the elongation of AL and the reduction of SCT after PDT in the treated eyes. This finding suggests that PDT may have a secondary morphological change in tissues (i.e., suprachoroidal space or sclera) other than choroid. During the active phase of CSC, the excessive fluid may pool in the submacular suprachoroidal space in association with the impaired choroidal outflow induced by the scleral thickening.
This is an abstract that was submitted for the 2017 ARVO Annual Meeting, held in Baltimore, MD, May 7-11, 2017.
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