How to predict success of photodynamic therapy in central serous chorioretinopathy

Session Details

Session Title: Free Paper Session 2: Vascular Diseases & Diabetic Retinopathy I

Session Date/Time: Thursday 07/09/2017 | 09:00-10:30

Paper Time: 09:00

Venue: Room 117

First Author: : P.Rodrigues PORTUGAL

Co Author(s): :    S. Frazao   R. Silva   S. Cruz   M. Marques   C. Ornelas   P. Rosa              

Abstract Details

Purpose:

To analyze eyes treated with Photodynamic Therapy (PDT) for Central Serous Chorioretinopathy (CSC) and study the factors influencing its outcome.

Setting:

Instituto de Oftalmologia Dr. Gama Pinto.

Methods:

Retrospective study of consecutive cases that were treated with half-fluence PDT for chronic CSC in 2015 and 2016. We evaluated the success in terms of post-treatment visual acuity (VA) and resolution of neurosensory detachment and correlated it with pre-operative variables such as VA, time of evolution, macular thickness and volume, diameter of neurosensory detachment, presence of pigmented epithelial detachment, bilateral affection and recurrence.

Results:

We analyzed 15 eyes from 12 patients (7 males), with a mean age of 46.58 years. Six patients had CSC for more than 1 year, 5 patients had bilateral CSC and 6 had recurrent disease. The mean VA before treatment was 59 letters (ETDRS) and 56 letters after treatment. The post-treatment VA had a statistically significant lower value in cases with symptoms for more than 1 year (p=0.027). Central macular thickness had an initial value of 314.4µm and a value of 238.2µm after treatment. Complete resolution of neurosensory detachment was observed in 9 eyes, with subsequent photoreceptor layer atrophy in 3. The resolution of neurosensory detachment was lower in eyes with recurrent disease, with statistical significance (p=0.048).

Conclusions:

The results show that, although effective in the resolution of neurosensory detachment, PDT has a limited role in improving vision in long-standing (over 1 year) cases of CSC, being much more effective in cases that are symptomatic for about 6 months. Besides time of evolution, the only other factor that was important to predict failure of the treatment was recurrent disease. This data shows the importance of early diagnosis and treatment of chronic CSC in order to achieve the best results.

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