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Efficacy of half-dose photodynamic therapy in steroid-associated chronic central serous chorioretinopathy: a case control study

Session Details

Session Title: Vascular Diseases and Diabetic Retinopathy

Session Date/Time: Friday 18/09/2015 | 11:00-12:30

Paper Time: 11:56

Venue: Calliope

First Author: : C.Boon NETHERLANDS

Co Author(s): :    D. Mohabati   M. Breukink   E. van Dijk   J. Keunen   G. Dijkman   C. Hoyng

Abstract Details

PURPOSE:Corticosteroid exposure has previously been suggested as a risk factor for the development of chronic central serous chorioretinopathy (cCSC). In this study we assess whether the therapeutic outcome of half-dose photodynamic therapy (PDT) is different in cCSC patients with prior exogenous corticosteroid use or endogenous hypercortisolism as compared to patients without any corticosteroid exposure.

Setting:

Retrospective case-control study in two academic tertiary referral centers.

Methods:

Retrospective review of the medical records of 121 patients (128 eyes) who had been diagnosed with cCSC and had received their first reduced-settings PDT between 2004 and 2014. Thirty-nine cCSC eyes had a history of corticosteroid exposure within 12 months prior to the moment of PDT (cases), and 89 eyes were without any exposure (controls). Cases with other retinal or choroidal comorbidities or the ones with an earlier treatment in the study eye were excluded. The main variables of interest included best-corrected visual acuity (BCVA), changes in central retinal thickness (CRT), and resolution of subretinal fluid (SRF) on optical coherence tomography (OCT). Statistical analyses were performed using independent t-test, Chi-square test and Mann Whitney test.

Results:

The mean BCVA before therapy was 69 ETDRS letters in case group and 73 ETDRS letters in control group (p=0.096). The mean BCVA at first follow-up after PDT (mean of 7.3 weeks post-therapy) was 76 ETDRS letters in cases and 74 ETDRS letters in the control group (p=0.515). In 26 cases (66.7%) there was a complete resolution of SRF while in control group there were 57 eyes (64.0%) with a complete resolution (p=0.775) at first follow-up. The mean CRT reduction on OCT was 88.7 µm versus 91.7 µm respectively in cases versus controls at first follow-up (p=0.899). The mean number of recurrences until the end of the study was 0.2 in both cases (n=27) and controls (n=50) (p=0.904). Both subjects in case group (n=39) as well as subjects in control group (n=89) underwent on average 1.7 treatments until the end of the study (p=0.937).

Conclusions:

Corticosteroid exposure does not seem to have a significant impact on functional and anatomical results of PDT treatment in cCSC.

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