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Abstract
Purpose
To quantify the development and resolution of serous retinal detachment in patients with choroidal neovascularization (CNV) following photodynamic therapy (PDT).
Methods
Six eyes of five patients who developed serous retinal detachment two days after PDT were included in this study. Retinal thickness was measured by optical coherence tomography (OCT) before PDT, and at two days, seven days, and three weeks after PDT. The number of PDT and the greatest linear dimension (GLD) of the CNV lesion were recorded.
Results
Serous retinal detachment was demonstrated on OCT at two days after PDT. Retinal elevation increased significantly from 313.2 pm before PDT to 640.7 pm two days after PDT (P<0.01); elevation and decreased to 303.2 pm seven days after PDT, and decreased to 223.4 pm three weeks after PDT. The mean number of PDT treatments 2.0 (range: 1∼3), and the mean GLD before PDT was 3122.8±1275.9 pm.
References
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Figure 1.
Fundus photograph 2 days after photodynamic therapy in a 56-year-old patient with choroidal neovascularization shows serous retinal detachment.
Figure 2.
Optical coherence tomography (OCT) before and after photodynamic therapy (PDT) in a 74-year-old patient (A, B, C, D) and a 71-year-old patient (a, b, c, d). (A, a) Before PDT (retinal elevation=304 pm and 360 pm, respectively), OCT images show a hyporeflective area in the subneuroretinal space due to fluid accumulation (arrowheads). Retinal thickness is indicated by arrows. (B, b) 2 days after PDT, OCT images show the large amount of fluid accumulation (increased retinal elevation=757 pm and 549 pm, respectively). (C, c) 7 days after PDT, OCT image shows that the subretinal fluid absorbed, resulting in reduced retinal elevation of 296 pm and 368 pm, respectively. (D, d) 3 weeks after PDT (slightly more decreased retinal elevation=276 pm and 274 pm, respectively).
Figure 3.
Optical coherence tomography (OCT) after photodynamic therapy (PDT) in a 56-year-old patient in both eyes. (A) 2 days after PDT, OCT images show the large amount of fluid accumulation in both eyes (increased retinal elevation=907 pm (OD) and 744 pm (OS)). At 3 days after PDT, intravitreal triamcinolone acetate injection was performed in the left eye, but no treatment was done in the right eye. (B) 7 days after PDT, OCT images show that the subretinal fluid absorbed nearly completely in both eyes, resulting in reduced retinal elevation of 205 pm (OD) and 399 pm (OS) (C) 3 weeks after PDT (more decreased retinal elevation=150 pm (OD) and 166 pm (OS)).
Figure 4.
Fluorescein angiograph (FAG) and Indocyanine green angiograph (ICG) before and 2 days after photodynamic therapy (PDT) in 66-year-old patient with choroidal neovascularization. (A) FAG before PDT (B) FAG 2 days after PDT shows serous retinal detachment (C) ICG before PDT (D) ICG 2 days after PDT
Table 1.
Retinal elevation was demonstrated by optical coherence tomography (OCT) in 6 cases of choroidal neovascularization (CNV) before, 2 days, 7 days, and 3 weeks after photodynamic therapy (PDT)
| Cases | Sex | Age (Yr) | CNV type | GLD* (μm) | No. of PDT |
Retinal elevation (pm) (Visual acuity) |
|||
|---|---|---|---|---|---|---|---|---|---|
| Prior to PDT | 2 days after PDT | 7 days after PDT | 3 wks after PDT | ||||||
| 1 | M | 74 | classic | 4738 | 2 | 304 (0.3) | 757 (0.1) | 296 (0.4) | 276 (0.8) |
| 2 | M | 71 | occult | 3100 | 2 | 360 (0.2) | 549 (0.1) | 368 (0.2) | 274 (0.15) |
| 3 | F | 56 | classic | 1650 | 3 | 258 (0.4) | 907 (0.15) | 205 (0.4) | 150 (0.5) |
| 4 | F | 56 | classic | 3600 | 3 | 387 (0.1) | 744 (0.06) | 399 (0.06) | 166 (0.04) |
| 5 | M | 53 | classic | 1609 | 1 | 368 (0.02) | 483 (0.15) | 347 (0.2) | 251 (0.3) |
| 6 | M | 66 | occult | 4040 | 1 | 202 (0.4) | 404 (0.2) | 204 (0.4) | N/A† |
| Mean | - | 66.7 | - | 3122.8 | 2.0 | 313.2 (0.25) | 640.7 (0.1) | 303.2 (0.3) | 223.4 (0.35) |
| SD | - | 14.3 | - | 1275.9 | 0.9 | 72.3 | 192.1 | 83.5 | 60.8 |
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