Abstract
Purpose :
The long-term effects of photodynamic therapy (PDT) on the retina in central serous chorioretinopathy (CSCR) patients are sparsely documented due to limited use of PDT. Previous literature explored PDT outcomes at an average of 2 years but not longer than 5 years. We conducted a retrospective observational study to evaluate the long-term results of PDT in patients with CSCR with at least 6 years follow up post-treatment.
Methods :
We analyzed electronic charts of patients with CSCR at Massachusetts Eye and Ear from 2006 to 2022. Those who underwent PDT with at least 6 years follow-up were selected if they didn’t have any history of choroidal neovascular membrane (CNVM), retinopathy, or over 20 anti-VEGF injections. We identified 28 eyes that underwent 43 PDT sessions across 26 patients. We used a Wilcoxon signed rank test to compare the best corrected visual acuity (BCVA) medians before PDT, 1 month after PDT and at final follow-up stratified by number of PDT sessions. Because some eyes underwent anti-vascular endothelial growth factor (VEGF) trials despite a lack of CNVM, we also conducted sensitivity analyses in the 22 eyes naïve to anti-VEGF.
Results :
Our cohort’s mean time from first PDT to final visit is 7.2±2.7 years. In eyes with PDT done once (n=18), BCVA change was not significant (pre-PDT BCVA= 0.4[0.1-0.9], post-PDT BCVA= 0.2[0-0.9], and final BCVA= 0.14[-0.12-2.28], p=0.065 and p=0.753 respectively). In eyes with PDT done at least twice (n=10), BCVA did not significantly change 1 month after the first PDT (BCVA pre-PDT= 0.3[0.18-0.6], BCVA post-PDT= 0.2[0-0.54], p=0.088); BCVA improved between the second pre-PDT and the final BCVA (BCVA pre-PDT= 0.25[0-0.9], final BCVA= 0.14[0-0.88], p=0.017). A sensitivity analysis was done for eyes with no anti-VEGF injections. In patients who had PDT once (n=15), BCVA significantly changed a month after PDT (BCVA pre-PDT= 0.4[0.1-0.8], BCVA post-PDT= 0.1[0-0.8], p=0.018) but this was lost at final follow-up (final BCVA= 0.1 [-0.1-2.28], p=0.306). In those who did PDT at least twice (n=7), no change in BCVA was observed (BCVA pre-PDT 2= 0.2 [0-0.9], final BCVA= 0[0-0.87], p=0.042).
Conclusions :
PDT was associated with short-term improvements in vision. The long-term outcomes were unchanged overall, suggesting that the use of PDT is associated with maintenance of baseline vision. Comparison to untreated CSCR patients will be important future work.
This abstract was presented at the 2023 ARVO Annual Meeting, held in New Orleans, LA, April 23-27, 2023.