June 2017
Volume 58, Issue 8
Open Access
ARVO Annual Meeting Abstract  |   June 2017
Combination Photodynamic Therapy and Anti-Vascular Endothelial Growth Factor for Recalcitrant Chronic Central Serous Chorioretinopathy
Author Affiliations & Notes
  • Andrew T Chon
    Clinical Research, Ophthalmology, Retina Macula Institute, Torrance, California, United States
    Western University of the Health Sciences, Pomona, California, United States
  • Masumi George Asahi
    Clinical Research, Ophthalmology, Retina Macula Institute, Torrance, California, United States
    Western University of the Health Sciences, Pomona, California, United States
  • Ron P Gallemore
    Clinical Research, Ophthalmology, Retina Macula Institute, Torrance, California, United States
  • Joshua Wallsh
    Clinical Research, Ophthalmology, Retina Macula Institute, Torrance, California, United States
  • Footnotes
    Commercial Relationships   Andrew Chon, None; Masumi Asahi, None; Ron Gallemore, None; Joshua Wallsh, None
  • Footnotes
    Support  None
Investigative Ophthalmology & Visual Science June 2017, Vol.58, 5930. doi:
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    • Get Citation

      Andrew T Chon, Masumi George Asahi, Ron P Gallemore, Joshua Wallsh; Combination Photodynamic Therapy and Anti-Vascular Endothelial Growth Factor for Recalcitrant Chronic Central Serous Chorioretinopathy. Invest. Ophthalmol. Vis. Sci. 2017;58(8):5930.

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      © ARVO (1962-2015); The Authors (2016-present)

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Abstract

Purpose : To determine whether combination photodynamic therapy (PDT) and anti-vascular endothelial growth factor (VEGF) therapy is effective in the management of chronic central serous chorioretinopathy (CSC) recalcitrant to conventional therapy.

Methods : A retrospective case series of 8 patients with chronic CSC unresponsive to topical non-steroidal anti-inflammatory drops, focal photocoagulation, anti-VEGF alone, or PDT alone. All patients were evaluated with a full ophthalmic exam, spectral-domain optical coherence tomography (SD-OCT), fluorescein angiography, and most with indocyanine green angiography followed by half-fluence PDT and intravitreal anti-VEGF injection (7 Bevacizumab, 1 Aflibercept). Patients were seen in follow-up one month after treatment.

Results : All 8 patients achieved complete resolution in subretinal fluid following combination treatment. Average duration of CSC prior to initiation of combination therapy was 4.25 months. Mean central macular thickness on SD-OCT decreased significantly from 401.2 +/- 52.7 microns to 297.9 +/- 18.2 microns (p=0.0010) by four months after treatment (1.63+/-1.18 months). 7 of 8 patients were followed for an average of 13 months with no recurrence during that time. One case recurred at eight months and was treated with repeat combination at that time. Frank CNV was not identified in these cases on FA or ICG studies. 8 of 8 patients showed significant improvement in vision from a logMAR of 0.1125 +/- 0.099 to 0.0125 +/- 0.064 (p=0.019).

Conclusions : Combination PDT and anti-VEGF is effective for chronic CSC which has failed conventional therapy. As high as 50% recurrence rate has been reported within 1-year after treatment of the first event with conventional therapy. Associated CNV and/or inflammation may be reasons for greater success in patients treated with combination therapy. A larger randomized controlled study is needed to confirm benefit of combination therapy for chronic CSC.

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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