Abstract
Introduction: :
Title: Results of Photodynamic Therapy with Verteporfin for the Treatment of Central Serous Chorioretinopathy
Purpose: :
To assess anatomic and visual results of Photodynamic Therapy with Verteporfin in patients with Central Serous Chorioretinopathy
Methods: :
We performed a retrospective review of nineteen eyes of 19 patients who presented with symptomatic Central Serous Chorioretinopathy (CSCR), treated with Photodynamic Therapy (PDT) with Verteporfin (Visudyne). Laser therapy was not considered due to the presence of foveal choroidal leaks or long standing poorly defined areas of leakage. All patients, before therapy, underwent complete ophthalmic examination, including Fluorescein Angiography and Optical Coherence Tomography (OCT). Patients received Photodynamic Therapy with full fluence, half fluence or half dose Verteporfin. Response to therapy was evaluated by post-PDT visual acuity, resolution of sub-retinal fluid confirmed on OCT, and reduced leakage on Fluorescein Angiography. Only eyes with chronic CSR for greater than 6 months or patients with complaints of severe visual dysfunction prohibiting normal daily activities were included. Patients were excluded if they had other causes of sub-retinal fluid other than CSCR or visual acuity worse than 20/200. No adjuvant therapies were used.
Results: :
Mean age of the treated patients was 52.65 years, with a range between 42 and 66 years; 84 % were males. Sub-retinal fluid was reduced in all 19 eyes after one PDT treatment, and only 4 eyes showed persistent swelling confirmed by OCT requiring an additional treatment. All eyes showed complete resolution of sub-retinal fluid by the last follow up visit. No eyes showed evidence of recurrence. Complete resolution of the serous detachment, documented with OCT, was achieved in all nineteen eyes. A 2 line mean visual acuity improvement was noted. Improvement of visual acuity was seen in 14 of 19 eyes (74%), no change in 4 eyes (21%), and worse in 1 of 19 eyes (5%) All patients reported a positive visual outcome or improvement in quality of life. Transient decrease in vision was seen in some patients who received full fluence PDT with full dose Verteporfin, and no long term complications were noted.
Conclusions: :
This review suggest that Photodynamic Therapy with Verteporfin can be implemented successfully in patients with Central Serous Chorioretinopathy, when laser therapy cannot be performed due to poorly defined choroidal leakage or focal leaks involving the foveal area.
Keywords: photodynamic therapy • choroid • retinal pigment epithelium