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Marco Nassisi, Camilla Alovisi, Carlo Lavia, Federico Grignolo, Chiara M Eandi; Short-term choriocapillary changes in patients with central serous chorioretinopathy after photodynamic therapy.. Invest. Ophthalmol. Vis. Sci. 2016;57(12):4953.
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© ARVO (1962-2015); The Authors (2016-present)
To investigate the short term effects of photodynamic therapy (PDT) at the level of the choriocapillary in patients with chronic central serous chorioretinopathy (CSC).
IRB approval was obtained for off-label use of verteporfin in CSC. Consecutive patients with chronic CSC (> 6 months) were enrolled. Baseline examination included: Best Corrected Visual Acuity (BCVA) with ETDRS charts, complete slit lamp exam, IOP measurement, fundus biomicroscopy, spectral domain OCT (SD-OCT) with the Enhanced Depth Imaging (EDI) mode (Spectralis, Heidelberg Engeneering), OCT angiography (Avanti RTVue XR, Optovue), angiography with fluorescein and green indocyanine (Spectralis, Heidelberg Engeneering). Half dose ICG guided 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 choriocapillary morphology were described by analyzing angio-OCT choroid cap images. Changes on central retinal thickness (CRT) and choroidal thickness at the level of the fovea were measured with the spectralis caliper tool.
Ten eyes of 10 patients with chronic CSC were enrolled. There were 9 men and the mean age was 53 year old (range 42 – 70 years). The mean BCVA at baseline was 20/50 and improved to 20/40 at 1 week and remained stable at 1 month. CRT decreased from 425 microns at baseline to 325 and 294 microns at one week and one month respectively with complete resolution of subretinal fluid. Similarly, choroidal thickness decreased in all eyes (405, 374, and 351 microns at baseline, one week, and one month, respectively). When analyzed at one week by the mean of the angio-OCT, the choriocapillary morphology showed peculiar alterations. In particular, the vessels have shrunk with a rarefaction of the vascular net and some lacunae. These findings were no more visible at one month.
These observations showed that half dose PDT treatment determines temporary changes at the level of the choriocapillary that might explain the resolution of the subretinal fluid. New imaging techniques are useful in understanding the pathogenesis of this multifactorial disease.
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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