Choroidal Anatomic Alterations After Photodynamic Therapy for Chronic Central Serous Chorioretinopathy: A Multicenter Study - 10/09/20

Doi : 10.1016/j.ajo.2020.04.022

Claudio Iovino ^a, Adrian Au ^b, Jay Chhablani ^c, Deepika C. Parameswarappa ^c, Mohammed Abdul Rasheed ^c, Gilda Cennamo ^d, Giovanni Cennamo ^e, Daniela Montorio ^e, Allen C. Ho ^f, David Xu ^f, Giuseppe Querques ^g, Enrico Borrelli ^g, Riccardo Sacconi ^g, Francesco Pichi ^h, Elizabeth Woodstock ^h, Srinivas R. Sadda ⁱ, Giulia Corradetti ⁱ, Camiel J.F. Boon ^j,^k, Elon H.C. van Dijk ^j, Anat Loewenstein ^l, Dinah Zur ^l, Sugiura Yoshimi ^m, K. Bailey Freund ^m, Enrico Peiretti ^a, David Sarraf ^b,^n,^⁎
^a Department of Surgical Sciences, Eye Clinic, University of Cagliari, Cagliari, Italy
^b Retinal Disorders and Ophthalmic Genetics Division, Stein Eye Institute, University of California, Los Angeles, California, USA
^c Smt. Kanuri Santhamma Centre for Vitreo-Retinal Diseases, L V Prasad Eye Institute, Hyderabad, Telangana, India
^d Eye Clinic, Public Health Department, University of Naples Federico II, Naples, Italy
^e Department of Neurosciences, Reproductive Sciences and Dentistry, University of Naples Federico II, Naples, Italy
^f Retina Service, Wills Eye Hospital, Philadelphia, Pennsylvania, USA
^g Ophthalmology Department, San Raffaele University Hospital, Milan, Italy
^h Cleveland Clinic Abu Dhabi, Eye Institute, Abu Dhabi, United Arab Emirates
ⁱ Doheny Eye Institute, University of California, Los Angeles, California, USA
^j Department of Ophthalmology, Leiden University Medical Center, Leiden, the Netherlands
^k Department of Ophthalmology, Amsterdam University Medical Centers, Academic Medical Center, University of Amsterdam, Amsterdam, the Netherlands
^l Division of Ophthalmology, Tel Aviv Sourasky Medical Center affiliated to Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
^m Vitreous Retina Macula Consultants of New York, New York, New York, USA
ⁿ Greater Los Angeles VA Healthcare Center, Los Angeles, California, USA

^∗Inquiries to David Sarraf, Retinal Disorders and Ophthalmic Genetics Division, Stein Eye Institute, University of California, Los Angeles, 100 Stein Plaza, Los Angeles, CA 90095-7002Retinal Disorders and Ophthalmic Genetics DivisionStein Eye InstituteUniversity of California, Los Angeles100 Stein PlazaLos AngelesCA90095-7002

Abstract

Purpose

To study the early anatomic choroidal alterations in eyes with chronic central serous chorioretinopathy (CSCR) undergoing photodynamic therapy (PDT).

Design

Multicenter retrospective cohort study.

Methods

A total of 77 patients and 81 eyes with chronic CSCR treated with PDT and 64 untreated fellow eyes were evaluated. Central macular thickness (CMT) and choroidal features including subfoveal choroidal thickness (SFCT), total choroidal area (TCA), luminal choroidal area (LCA), and stromal choroidal area (SCA) were analyzed. Choroidal vascularity index (CVI) was calculated in all study eyes at baseline and at 1- and 3-months post-PDT.

Results

In eyes receiving PDT, Snellen visual acuity (VA) significantly improved at months 1 and 3 (P < .001). CMT and SFCT showed a significant reduction from baseline at months 1 and 3 (P < .001), whereas TCA and LCA showed a significant decrease only at the 1-month follow-up visit. Baseline mean TCA and LCA were 2.30 ± 1.41 mm² and 1.23 ± 0.73 mm², respectively, and decreased to 2.07 ± 1.21 mm² and 1.08 ± 0.63 mm² at the 1-month follow-up visit, respectively (P = .01). No significant changes were recorded for SCA and CVI. In the fellow eye group, VA, CMT, and all choroidal parameters showed no differences between baseline and any follow-up visits (all P > .05).

Conclusions

After PDT for chronic CSCR we observed sustained reductions in CMT and SFCT, while reductions in TCA and LCA were only noted at the 1-month follow-up interval. These choroidal parameters may provide additional quantitative biomarkers to evaluate the anatomic response to therapy but await further prospective validation.

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Vol 217

P. 104-113 - septembre 2020 Retour au numéro

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Choroidal Anatomic Alterations After Photodynamic Therapy for Chronic Central Serous Chorioretinopathy: A Multicenter Study - 10/09/20

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