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Oh, Kwon, Kim, Kim, Kim, Kim, Nam, Park, Sohn, Oum, Yu, Yoon, Yoon, Yoon, Lee, Lee, Lee, Chang, Cho, Chin, Huh, and Kwak: Photodynamic Therapy for Chronic Central Serous Chorioretinopathy: Multicenter Study of 65 Cases
Original Article

J Korean Ophthalmol Soc 2009;50(3):390-398.

Published online: 31 August 2009

DOI: https://doi.org/10.3341/jkos.2009.50.3.390

Photodynamic Therapy for Chronic Central Serous Chorioretinopathy: Multicenter Study of 65 Cases

Jaeryung Oh, MD1, Oh Woong Kwon, MD2, Min Ho Kim, MD3, Jong In Kim, MD4, Ha Kyoung Kim, MD5, Hyung Chan Kim, MD6, Dong Heun Nam, MD7, Kyu-Hyung Park, MD8, Joon Hong Sohn, MD9, Boo Sup Oum, MD10, Seung Young Yu, MD11, Young Hee Yoon, MD12, Ill Han Yoon, MD13, Hee Sung Yoon, MD14, Jae-Heung Lee, MD4, Jeong Hee Lee, MD15, Ji Eun Lee, MD10, Woo Hyok Chang, MD16, Sung-Won Cho, MD4, Hee Seung Chin, MD17, Kuhl Huh, MD1, Hyung Woo Kwak, MD11

1Department of Ophthalmology, Korea University College of Medicine, Seoul, Korea

2Department of Ophthalmology, Yonsei University College of Medicine, Seoul, Korea

3Apgujung St. Mary's Eye Hospital, Seoul, Korea

4Department of Ophthalmology, Konyang University, Kim's Eye Hospital, Seoul, Korea

5Department of Ophthalmology, Hallym University College of Medicine, Seoul, Korea

6Department of Ophthalmology, Konkuk University College of Medicine, Seoul, Korea

7Department of Ophthalmology, Gachon University Gil Medical Center, Incheon, Korea

8Department of Ophthalmology, Seoul National University College of Medicine, Seoul, Korea

9HanGil Eye Hospital, Incheon, Korea

10Department of Ophthalmology, College of Medicine, Pusan National University, Pusan, Korea

11Department of Ophthalmology, KyungHee University College of Medicine, Seoul, Korea

12Department of Ophthalmology, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea

13Department of Ophthalmology, College of Medicine, Inje Universtiy, Pusan, Korea

14Sungmo Eye Hospital, Pusan, Korea

15Department of Ophthalmology, College of Medicine, Ewha Womans University, Seoul, Korea

16Department of Ophthalmology, Yeungnam University College of Medicine, Daegu, Korea

17Department of Ophthalmology, Inha University School of Medicine, Incheon, Korea

Address reprint requests to Hyung Woo Kwak, MD, Department of Ophthalmology, KyungHee University College of Medicine #1 Hoeki-dong, Dongdaemun-gu, Seoul 130-702, Korea Tel: 82-2-958-8451 Fax: 82-2-966-7340, E-mail: pbloadsky@naver.com

Received 7 August 2008       Accepted 30 September 2008

Copyright © 2009 Korean Ophthalmological Society

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Purpose

To determine the effect of photodynamic therapy (PDT) on patients with chronic central serous chorioretinopahty (CSC).

Methods

This was a retrospective multicenter study. We collected demographic and ophthalmic data for patients with chronic CSC who were treated with PDT from 16 institutions in Korea. The best corrected visual acuity (BCVA), ophthalmoscopic finding and optical coherence tomography at baseline and follow-up visits were compared longitudinally.

Results

Sixty-five eyes of 65 patients were recruited. Males (51 patients, 78.5%) outnumbered females (14 patients, 21.5%). The mean age was 46.4±10.0 years of age (28∼69). By 1 month, mean BCVA improved from 0.47 to 0.37 (logarithm of the minimum angle of resolution) (P<0.01). This BCVA increased throughout 6 months. Subretinal fluid resolved partially or completely in 89.1% of the patients. Central macular thickness (CMT) decreased from 303.4 to 168.7 μ m. The amount of change in CMT after PDT was correlated to the female sex and prePDT CMT. At 3 months after PDT, the amount of change in BCVA was significantly related to that of change of CMT (p <0.05). Adverse events were reported in 4 cases, however, most were mild.

Conclusions

PDT was effective and safe for treating chronic CSC.

Keywords: BCVA, Chronic CSC, CMT, PDT

References

1. Gass JD. Pathogenesis of disciform detachment of the neuro- epithelium. II. Idiopathic central serous choroidopathy. Am J Ophthalmol. 1967; 63:587–615.
2. Jalkh AE, Jabbour N, Avila MP, et al. Retinal pigment epithelium decompensation. I. Clinical features and natural course. Ophthalmology. 1984; 91:1544–8.
3. Loo RH, Scott IU, Flynn HW Jr, et al. Factors associated with reduced visual acuity during long-term follow-up patients with idiopathic central serous chorioretinopathy. Retina. 2002; 22:19–24.
4. Leaver P, Williams C. Argon laser photocoagulation in the treatment of central serous retinopathy. Br J Ophthalmol. 1979; 63:674–7.
crossref
5. Robertson DM, Ilstrup D. Direct, indirect and sham laser photocoagulation in the management of central serous chorioretinopathy. Am J Ophthalmol. 1983; 95:457–66.
crossref
6. Jalk AE, Jabbour N, Avila M, et al. Retinal pigment epithelium decompensation. II. Laser treatment. Ophthalmology. 1984; 91:1549–53.
7. Kim HC, Kim HK. Choroidal neovascularization in patients with chronic central serous chorioretinopathy. J Korean Ophthalmol Soc. 2000; 41:684–90.
8. Lai TY, Chan WM, Li H, et al. Safety enhanced photodynamic therapy with half dose verteporfin for chronic central serous chorioretinopathy: a short term pilot study. Br J Ophthalmol. 2006; 90:869–74.
crossref
9. Cardillo Piccolino F, Eandi CM, Ventre L, et al. Photodynamic therapy for chronic central serous chorioretinopathy. Retina. 2003; 23:752–63.
10. TAP Study Group. Photodynamic therapy of subfoveal choroidal neovascularization in age-related macular degeneration with verteporfin. One-year results of 2 randomized clinical trials. TAP report 1. Arch Ophthalmol. 1999; 117:1329–45.
11. Wang MS, Sander B, Larsen M. Retinal atrophy in idiopathic central serous chorioretinopathy. Am J Ophthalmol. 2002; 133:787–93.
12. Tittl MK, Spaide RF, Wong D, et al. Systemic and ocular findings in central serous chorioretinopathy. Am J Ophthalmol. 1999; 128:63–8.

Figure 1.
Distribution of methods (A) used to determine the area for photodynamic treatment and protocols (B).
jkos-50-390f1.tif
Figure 2.
Change of visual acuity after photodynamic treatment. By 1 month, mean visual acuity was improved from 0.47 to 0.37 logarithm of the minimum angle of resolution (p <0.01, paired t-test). This visual improvement increased until 6 months after treatment.
jkos-50-390f2.tif
Figure 3.
Change of the mean central macular thickness after photodynamic treatment. By 1 month, the mean central macular thickness decreased from 303.4 to 168.7 μm (p<0.001, paired t-test). This macular thickness was maintained after then.
jkos-50-390f3.tif
Figure 4.
Comparison of the central macular thickness in baseline and 1 month (A) or 3 months (B) after photodynamic treatment.
jkos-50-390f4.tif
Table 1.
Factors related to the change of vision at 1 month and 3 months after photodynamic treatment (linear regression analysis)
  At 1 month At 3 months
Univariate Multivariate (R2=0.278) Univariate Multivariate (R2=0.455)
B p-value B p-value B p-value B p-value
Age 0.005 0.021 0.004 0.096 0.001 0.788    
Female   0.043* 0.078 0.158   0.177*   0.497
Duration 0.176 0.243     −0.001 0.045 −0.134 0.062
Leakage pattern   0.330†       0.638†    
PED   0.867*       0.814*    
Decision   0.810†       0.252†    
Amount   0.085† 0.036 0.102   0.350†    
CMT‡ baseline <0.001 0.063 0.000 0.116 <0.001 0.072 −0.001 0.113
CMT change <0.001 0.489     0.001 0.011 0.001 0.042
Vision pre 0.113 0.089 0.090 0.184 0.097 0.267    

*Paired t-test

†One-way ANOVA

‡Central macular thickness.

Table 2.
Factors related to the change of central macular thickness at 1 month and 3 months after photodynamic treatment (linear regression analysis)
  At 1 month At 3 months
Univariate Multivariate (R2=0.813) Univariate Multivariate (R2=0.789)
B p-value B p-value B p-value B p-value
Age −0.931 0.667     3.371 0.078 0.324 0.816
Female   0.014*   0.011   0.009*   0.020
Duration 1.156 0.254     −33.382 0.348    
Leakage pattern   0.047† 0.799 0.977   0.138†    
PED   0.292*       0.048*   0.807
Decision   0.172†       0.428†    
Amount   0.914†       −    
CMT‡ baseline 1.035 <0.001 0.984 <0.001 0.776 <0.001 0.615 <0.001
Vision baseline 55.798 0.408     −63.532 0.344    
Vision change 96.248 0.489     262.547 0.011 127.603 0.032

*Paired t-test

†One-way ANOVA

‡Central macular thickness.

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