June 2022
Volume 63, Issue 7
Open Access
ARVO Annual Meeting Abstract  |   June 2022
Treatment of Peripapillary Pachychoroid Syndrome
Author Affiliations & Notes
  • Suzanne Yzer
    Ophthalmology, Radboudumc, Nijmegen, Gelderland, Netherlands
    Rotterdam Eye Hospital, Rotterdam, Netherlands
  • Alexander Pothof
    Rotterdam Eye Hospital, Rotterdam, Netherlands
  • Jose Martinez
    Rotterdam Eye Hospital, Rotterdam, Netherlands
  • Francine F Behar-Cohen
    Hopital Cocin Opthalmopole, Paris, France
  • Footnotes
    Commercial Relationships   Suzanne Yzer None; Alexander Pothof None; Jose Martinez None; Francine Behar-Cohen None
  • Footnotes
    Support  none
Investigative Ophthalmology & Visual Science June 2022, Vol.63, 3765 – F0186. doi:
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      Suzanne Yzer, Alexander Pothof, Jose Martinez, Francine F Behar-Cohen; Treatment of Peripapillary Pachychoroid Syndrome. Invest. Ophthalmol. Vis. Sci. 2022;63(7):3765 – F0186.

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

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Purpose : To evaluate the treatment response to topical steroidal eye drops in peripapillary pachychoroid syndrome (PPS)

Methods : In an observational study we examined 15 patients (21 eyes) with a diagnosis of PPS. Patients were followed for 2-10 years prior to topical steroidal treatment without any signs of reduction of the cysts, even upon the more classical treatments like photodynamic therapy or oral acetolozamide. All included patients received topical Pred Forte 10mg/ml (PF) 3-times daily for four weeks. Upon a good response (absence of cysts) the topical steroids were tapered off by one drop a month.

Results : Of the included 21 eyes, baseline visual acuity (VA) was 20/30. The median choroidal thickness was 202um at 3mm nasal of the fovea, 369um 1.5 nasal of the fovea, and 430um subfoveal. All patients showed a good anatomical response to topical steroids on OCT. Six patients experienced prolonged reduction of cysts even when dosage was reduced to once daily. On tapering of PF, 3 patients (4 eyes) had recurrence of cysts that subsequently disappeared when dosage was increased. The VA improved in 9 eyes, remained unchanged in 5 and decreased in 3 eyes. Seven eyes experienced elevated IOP (range 26-32mmHg), for which in 2 eyes PF was discontinued upon which cysts recurred.

Conclusions : In this observational study for recalcitrant cystic changes secondary to PPS we saw a favorable response to topical steroids in all 15 cases (21 eyes). During tapering off of the steroidal drug recurrence of the cysts was seen that disappeared again upon increasing the topical drugs. The disappearance of the cysts resulted in better reading vision and better contrast but only mildly improved VA. Topical steroids may be a viable treatment option in PPS.

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



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