J Korean Ophthalmol Soc.  2008 Jul;49(7):1078-1086. 10.3341/jkos.2008.49.7.1078.

Photodynamic Therapy with Vertepofin for Short Time for Chronic Central Serous Chorioretinopathy

• Kim JL
• Kim HW
• Yoon IH

• KMID: 1476961
• DOI: http://doi.org/10.3341/jkos.2008.49.7.1078

Abstract

PURPOSE
To evaluate the clinical results of short duration photodynamic therapy (PDT) using verteporfin in patients with chronic central serous chorioretinopathy (CSC).
METHODS
We retrospectively examined 15 eyes after PDT for chronic central serous chorioretinopathy. PDT for 83 seconds was evaluated for 8 eyes, and PDT for 60 seconds was evaluated for 7 eyes. Improvement in vision and changes in central macular thickness were evaluated with an optical coherence tomogram (OCT), and improvement in leaking was evaluated with a fluorescein angiogram (FA). Recurrence was also studied.
RESULTS
Visual acuity improved from 0.39 to 0.57 (p=0.04), and the mean central macular thickness decreased from 426.29 micrometer to 184.71 micrometer (p<0.01) in 7 eyes treated with PDT for 60 seconds. There was no significant change in visual acuity between the two groups (p=0.77) or in central macular thickness (p=0.52). Central macular exudation resolved completely in all eyes. After PDT, there was no recurrence during the follow-up period.
CONCLUSIONS
Short duration PDT with verteporfin appears to be a beneficial treatment option for patients with chronic CSC.

Keyword

Chronic central serous chorioretinopathy; Indocyanine green angiography; Optical coherence tomography; Photodynamic therapy

MeSH Terms

Central Serous Chorioretinopathy
Eye
Fluorescein
Follow-Up Studies
Humans
Photochemotherapy
Porphyrins
Recurrence
Retrospective Studies
Tomography, Optical Coherence
Triazenes
Vision, Ocular
Visual Acuity
Fluorescein
Porphyrins
Triazenes

Figure

• 

  Figure 1. Fluorescein angiogram and indocyanine green angiographic findings in the central serous chorioretinopathy. (A) Late phase fluorescein angiograph (FA) with characteristic leakage around the central macular consistent with central serous chorioretinopathy (CSC). (B) Late phase indocyanine green angiograph (ICGA) showing late extravascular leakage and hyperperfusion characteristic of CSC. Large choroidal vessels in the same area are visible. The circle represents the location and the size of the laser spot in photodynamic therapy (PDT).

• 

  Figure 2. The left eye of patient no. 6 (Table 1), a 42-year-old man, with central serous chorioretinopathy (CSC) showing a shallow submacular neurosensory retinal detachment and persistent focal retinal pigment epithelium (RPE) leakage of 9 months duration, who was treated with vertepofin PDT for 83 seconds. (A) Late phase FA with characteristic leakage around the central macula consistent with CSC. (B) Late phase FA 3 months after PDT shows minimal changes of the pigment epithelial pigmentation and fluorescence around the macular region. (C) The pre-PDT OCT showing a shallow submacular neurosensory retinal detachment. The visual acuity at this time was 0.32. (D) The OCT 3 months after PDT demonstrates complete resolution of the macular detachment. The visual acuity improved to 0.5.

• 

  Figure 3. The left eye of patient no. 9 (Table 1), a 46-year-old man, with central serous chorioretinopathy (CSC) showing a submacular neurosensory retinal detachment and persistent focal retinal pigment epithelium (RPE) leakage of 6 months duration, who was treated with vertepofin PDT for 60 seconds. (A) Late phase FA with characteristic leakage around the central macula consistent with central CSC. The visual acuity was 0.32. (B) Late phase FA 3 months after PDT shows no angiogenic leakage and minimal changes of the pigment epithelial pigmentation around the macular region. (C) The pre-PDT OCT showed the presence of subretinal fluid at the central macula. (D) The OCT 3 months after PDT demonstrates complete resolution of the macular detachment. The visual acuity improved to 0.4.

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