Abstract
Purpose :
To investigate the efficacy of photodynamic therapy (PDT) combined with intravitreal anti-vascular endothelial growth factor (VEGF) therapy or alone for central serous chorioretinopathy (CSC) with choroidal neovascularization (CNV) by optical coherence tomography angiography (OCTA).
Methods :
A total of 27 eyes of 27 patients (18 men / 9 women, mean age 63.3 ± 10.3 years) with CSC and CNV, treated and followed for 3 months or more between June 2016 and May 2018 at Hyogo College of Medicine were examined. Patients with CSC were identified by fluorescein and indocyanine green angiography, and network structure in the outer retina and choriocapillaris was determined by OCTA. Sixteen (16) patients underwent PDT alone (the PDT group) and 11 underwent PDT combined with intravitreal anti-VEGF therapy within 3 days beforehand (the combination group). We analyzed best corrected visual acuity (BCVA), changes in subretinal fluid, central retinal thickness, subfoveal choroidal thickness, and CNV area before PDT and 1, 3, and 6 months after treatment for each single-treatment group and the combination group.
Results :
For the PDT group, logMAR BCVA did not change significantly after treatment. In the combination group, logMAR BCVA improved significantly at 3 and 6 months from baseline (p = 0.043 and p = 0.012). Subretinal fluid was resolved in 62.5% of the cases at 1 month after treatment, 75.0% at 3 months, and 58.3% at 6 months for the PDT group. For the combination group, the rate was 72.7% at 1 month, 72.7% at 3 months, and 66.7% at 6 months. Mean central retinal thickness was significantly reduced at 1, 3 and 6 months for the PDT group and for the combination group. Subfoveal choroidal thickness was significantly reduced at 3 and 6 months for the PDT group (p = 0.0002 and p = 0.021), and at 1, 3 and 6 months for the combination group (p = 0.001, p = 0.001,and p = 0.008). The total CNV area did not significantly change in the PDT group. In the combination group, it was significantly decreased at 1 and 3 months (p = 0.023 and p = 0.037).
Conclusions :
PDT combined with anti-VEGF therapy or alone for CSC with CNV significantly improved central retinal thickness and subretinal fluid amounts, but anti-VEGF therapy is necessary to decrease the CNV area.
This abstract was presented at the 2019 ARVO Annual Meeting, held in Vancouver, Canada, April 28 - May 2, 2019.