June 2022
Volume 63, Issue 7
Open Access
ARVO Annual Meeting Abstract  |   June 2022
Safety and efficacy of fovea-involving half-dose photodynamic therapy for chronic central serous chorioretinopathy
Author Affiliations & Notes
  • Helena Margaret Anthonia Feenstra
    Ophthalmology, Leids Universitair Medisch Centrum, Leiden, Zuid-Holland, Netherlands
  • Roselie M.H. Diederen
    Ophthalmology, Amsterdam UMC Locatie AMC, Amsterdam, North Holland, Netherlands
  • Martine J.C.M. Lamme
    Ophthalmology, Leids Universitair Medisch Centrum, Leiden, Zuid-Holland, Netherlands
  • Sascha Fauser
    Ophthalmology, Uniklinik Koln, Koln, Nordrhein-Westfalen, Germany
  • Susan M. Downes
    Ophthalmology, Oxford Eye Hospital, Oxford, Oxfordshire, United Kingdom
  • Reinier O. Schlingemann
    Ophthalmology, Amsterdam UMC Locatie AMC, Amsterdam, North Holland, Netherlands
  • Carel C B Hoyng
    Ophthalmology, Radboudumc, Nijmegen, Gelderland, Netherlands
  • Elon H.C. van Dijk
    Ophthalmology, Leids Universitair Medisch Centrum, Leiden, Zuid-Holland, Netherlands
  • Camiel J F Boon
    Ophthalmology, Leids Universitair Medisch Centrum, Leiden, Zuid-Holland, Netherlands
    Ophthalmology, Amsterdam UMC Locatie AMC, Amsterdam, North Holland, Netherlands
  • Footnotes
    Commercial Relationships   Helena Feenstra None; Roselie Diederen None; Martine Lamme None; Sascha Fauser None; Susan Downes None; Reinier Schlingemann None; Carel Hoyng None; Elon van Dijk None; Camiel Boon None
  • Footnotes
    Support  Stichting Blindenhulp; Stichting Macula Fonds; Retina Nederland Onderzoek Fonds; Stichting Blinden-Penning; Algemene Nederlandse Vereniging ter Voorkoming van Blindheid; Landelijke Stichting voor Blinden en Slechtzienden; Oogfonds, which contributed through UitZicht (Delft, the Netherlands); Rotterdamse Stichting Blindenbelangen (Rotterdam, the Netherlands); Stichting Leids Oogheelkundig Ondersteuningsfonds (Leiden, the Netherlands); Stichting Ooglijders (Rotterdam, the Netherlands); the Gisela Thier Fellowship of Leiden University, Leiden, the Netherlands (CB); and the Netherlands Organization for Scientific Research (VENI grant to CB).
Investigative Ophthalmology & Visual Science June 2022, Vol.63, 37. doi:
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    • Get Citation

      Helena Margaret Anthonia Feenstra, Roselie M.H. Diederen, Martine J.C.M. Lamme, Sascha Fauser, Susan M. Downes, Reinier O. Schlingemann, Carel C B Hoyng, Elon H.C. van Dijk, Camiel J F Boon; Safety and efficacy of fovea-involving half-dose photodynamic therapy for chronic central serous chorioretinopathy. Invest. Ophthalmol. Vis. Sci. 2022;63(7):37.

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

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Abstract

Purpose : Including the fovea in the treatment spot during half-dose photodynamic therapy (PDT) in chronic central serous chorioretinopathy (cCSC) still is a topic of controversy, since a risk of developing foveal atrophy after PDT has been previously suggested. We performed a retrospective study with data from prospective randomized controlled trials, to assess the risk of foveal atrophy, as well as the likelihood of structural and functional improvement on OCT, after half-dose PDT treatment of cCSC that included the fovea.

Methods : In the randomized controlled trials PLACE and SPECTRA, a total of 57 cCSC patients received half-dose PDT with a treatment spot that included the fovea at least partially, and were included in the current study. Optical coherence tomography (OCT) scans were analyzed for signs of foveal atrophy, as well as structural improvement, at baseline visit, at 8-12 weeks, 1, and 2 years after half-dose PDT. Fluorescein angiograms (FA) at baseline visit and at 8-12 weeks were analyzed for the presence of an RPE window defect. Main outcome measures were integrity of the external limiting membrane (ELM) and the ellipsoid zone (EZ). Secondary outcomes involved best-corrected visual acuity (BCVA) in Early Treatment of Diabetic Retinopathy Study (ETDRS) letters, and retinal sensitivity on microperimetry.

Results : The ELM was considered intact at baseline in 21/57 (36.8%) of patients, increasing to 56/57 (98.2%; p<0.001) at 1 year, and 50/51 (98.0%; p<0.001) at 2 years. The EZ was intact at first visit after SRF resolution in 5/57 (8.8%). At 1 year after half-dose PDT, 30/57 (52.6%) of patients had regained an EZ with a completely normal aspect (p<0.001), which increased to 32/57 (56.1%) at 2 years after baseline visit (p<0.001). None of the patients showed a deterioration of the foveal ELM or EZ after treatment. No window defects on FA were seen foveally either before- or after treatment. Mean BCVA and retinal sensitivity improved significantly at 1 year after treatment (+6.72 ±7.34 ETDRS letters, p<0.001, and +3.88 ±2.22 dB, p<0.001, respectively), compared to baseline.

Conclusions : In patients with cCSC who received half-dose PDT with inclusion of the fovea in the treatment spot, a significant improvement in structural and functional parameters was seen at 2 years of follow-up. None of the patients had evidence of development of PDT-associated foveal atrophy.

This abstract was presented at the 2022 ARVO Annual Meeting, held in Denver, CO, May 1-4, 2022, and virtually.

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