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Chiara M Eandi, Camilla Alovisi, Marco Nassisi, Carlo Lavia, Federico Grignolo; Short-term effects of photodynamic therapy on choroidal neovessels in central serous chorioretinopathy.. Invest. Ophthalmol. Vis. Sci. 2016;57(12):2160.
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© ARVO (1962-2015); The Authors (2016-present)
To investigate the short term effects of photodynamic therapy (PDT) on choroidal neovascular membrane (CNV) complicating chronic central serous chorioretinopathy (CSC).
IRB approval was obtained for off-label use of verteporfin in CSC. Consecutive patients with chronic CSC (> 6 months) and CNV were enrolled. At baseline visit the patients underwent to Best Corrected Visual Acuity (BCVA) with ETDRS charts, fundus biomicroscopy, spectral domain OCT (SD-OCT) with the Enhance Depth Imaging (EDI) mode (Spectralis, Heidelberg Engeneering), OCT angiography (Avanti RTVue XR, Optovue), angiography with fluorescein and green indocyanine (Spectralis, Heidelberg Engeneering). CNV was identified on angio-OCT in the area corresponding to RPE ondulation or on ICG angiography. Half dose photodynamic therapy (PDT) was then performed. BCVA, SD-OCT, and angio-OCT were repeated at one hour, one week, and one month after PDT treatment. Changes on central retinal thickness (CRT) and choroidal thickness at the level of the fovea were measured with the spectralis caliper tool. Vascular area was automatically measured with the AngioVue software at baseline, one hour, one week, and one month.
Six eyes of 6 patients with chronic CSC were enrolled. There were 5 men and the mean age was 61 year old (range 59 – 63 years). The mean BCVA at baseline was 20/32, 20/50 at 1 week and improved to 20/32 at 1 month. CRT decreased from a mean of 353 microns at baseline to 277 at 1 week and 272 at one month, respectively with complete resolution of subretinal fluid. Similarly, choroidal thickness decreased in all eyes (317, 279, and 294 microns at baseline, one week, and one month, respectively). The analysis of the CNV revealed that already after one week the vascular area was also reduced from 0.430 sqmm at baseline to 0.079 sqmm. At month one the mean area was 0.303. At month 3, the mean BCVA was 20/50 with a mean CRT and CHT of 280 and 375 microns respectively. The vascular area increased to 0.399 sqmm.
This study showed that half dose PDT treatment determines an immediate but temporary decrease of vascular area of the CNV associated to chronic CSC. Long term safety and efficacy of this therapeutic approach need to be investigated.
This is an abstract that was submitted for the 2016 ARVO Annual Meeting, held in Seattle, Wash., May 1-5, 2016.
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