July 2018
Volume 59, Issue 9
Open Access
ARVO Annual Meeting Abstract  |   July 2018
Clinical characteristics of chronic central serous chorioretinopathy patients with insufficient response to reduced-settings photodynamic therapy
Author Affiliations & Notes
  • Thomas Jurian van Rijssen
    Ophthalmology, Leiden University Medical Center, Leiden, Zuid-Holland, Netherlands
  • Elon H. Van Dijk
    Ophthalmology, Leiden University Medical Center, Leiden, Zuid-Holland, Netherlands
  • Greet Dijkman
    Ophthalmology, Leiden University Medical Center, Leiden, Zuid-Holland, Netherlands
  • Camiel Boon
    Ophthalmology, Leiden University Medical Center, Leiden, Zuid-Holland, Netherlands
    Ophthalmology, Amsterdam Medical Center, Amsterdam, Netherlands
  • Footnotes
    Commercial Relationships   Thomas van Rijssen, None; Elon Van Dijk, None; Greet Dijkman, None; Camiel Boon, None
  • Footnotes
    Support  None
Investigative Ophthalmology & Visual Science July 2018, Vol.59, 3134. doi:
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      Thomas Jurian van Rijssen, Elon H. Van Dijk, Greet Dijkman, Camiel Boon; Clinical characteristics of chronic central serous chorioretinopathy patients with insufficient response to reduced-settings photodynamic therapy. Invest. Ophthalmol. Vis. Sci. 2018;59(9):3134.

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

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Abstract

Purpose : Little is known about parameters that influence the outcome of photodynamic therapy (PDT) in chronic central serous chorioretinopathy (cCSC). We performed a retrospective, observational clinical study to identify characteristics of cCSC patients based on PDT outcome.

Methods : Caucasian cCSC patients treated with reduced-settings PDT were divided into a successful PDT group and unsuccessful PDT group. Patients in the successful PDT group did not have any subretinal fluid (SRF) during follow-up after PDT, whereas the unsuccessful PDT group was categorized based on persistence or recurrence of SRF after PDT treatment. Data on age, sex, best-corrected visual acuity (BCVA), characteristics on fluorescein angiography (FA) and indocyanine green angiography (ICGA), posterior cystoid degeneration, and PDT spot size were obtained. Logistic regression was performed to ascertain the effects of these parameters on PDT outcome. BCVA, subfoveal choroidal thickness (SFCT), and central foveal thickness were obtained during follow-up.

Results : Patients in the successful PDT group (20 males, 7 females) had a mean age of 52 years. In the unsuccessful PDT group, 20 males with a mean age of 60 years were included. At last visit before PDT, age, the percentage of males, and percentage of patients with diffuse leakage larger than 1 optic disc diameter on FA were significantly higher in the unsuccessful PDT group (p=0.010, p=0.015 and p=0.007, respectively). At last visit before PDT, BCVA and the percentage of patients with intense hyperfluorescence on ICGA were significantly lower in the unsuccessful group (p=0.028 and p=0.003, respectively). Patients with intense hyperfluorescence on ICGA were 22 times (95% CI 1.3-333) more likely to have a successful outcome (p=0.045). In both the successful and unsuccessful PDT groups, there was a significant decrease in SFCT at final visit (-111 µm, p=0.013 and -141 µm p=0.007, respectively). BCVA only improved significantly at final visit in the successful PDT group (5 Early Treatment of Diabetic Retinopathy Study letters, p<0.001).

Conclusions : cCSC patients with recurrent or persistent SRF after PDT are characterized by a higher percentage of males, more patients with diffuse leakage on FA, more patients without intense hyperfluorescence on ICGA, higher age, and lower pre-PDT and long-term BCVA than in the successful PDT group.

This is an abstract that was submitted for the 2018 ARVO Annual Meeting, held in Honolulu, Hawaii, April 29 - May 3, 2018.

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