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Lim, Chang, and Sagong: Photodynamic Therapy for Chronic Central Serous Chorioretinopathy According to Degree of Choroidal Hyperfluorescence
Original Article
Journal of the Korean Ophthalmological Society

Journal of the Korean Ophthalmological Society 2012; 53(2): 268-275.

Published online: 15 February 2012

DOI: https://doi.org/10.3341/jkos.2012.53.2.268

Photodynamic Therapy for Chronic Central Serous Chorioretinopathy According to Degree of Choroidal Hyperfluorescence

Su-Ho Lim, MD, Woo Hyok Chang, MD, Min Sagong, MD, PhD

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

Address reprint requests to Min Sagong, MD, PhD. Department of Ophthalmology, Yeungnam University Medical Center, #170 Hyeonchung-ro, Nam-gu, Daegu 705-717, Korea. Tel: 82-53-620-4191, Fax: 82-53-626-5936, msagong@ynu.ac.kr

Received 27 May 2011       Accepted 23 November 2011

Copyright © 2012 The Korean Ophthalmological Society

Abstract

Purpose

To compare the efficacy of photodynamic therapy (PDT) depending on the degree of hyperfluorescence based on indocyanine green angiography (ICGA) for treating chronic central serous chorioretinopathy (CSC).

Methods

Twenty-three eyes of 23 patients with chronic CSC were recruited for the present study. The minimum follow-up period was six months. The total energy of PDT was reduced to 25 J/cm2 for 83 seconds. The baseline middle-phase ICGA findings were classified as intense or low hyperfluorescence depending on the degree of hyperpermeability from choriocapillaris. The change in mean best-corrected visual acuity, the resolution of subretinal fluid, recurrence rate, and complication were analyzed in relation to each ICGA finding at baseline.

Results

The baseline ICGA findings showed intense hyperfluorescence in 11 eyes (47.8%) and low hyperfluorescence in 12 eyes (52.2%). The subretinal fluid resolved completely one month after a single application of low-fluence PDT in both groups. The subretinal fluid recurred in one of 12 eyes (8.3%) with low hyperfluorescence and in no eyes (0%) with intense hyperfluorescence. There was no statistically significant difference in the rate of recurrence between the two groups.

Conclusions

Low-fluence PDT appears to be an effective and safe treatment option for long-standing chronic CSC regardless of the degree of hyperfluorescence based on the ICGA.

Keywords: Chronic central serous chorioretinopathy, Indocyanine green angiography, Photodynamic therapy

Figures and Tables

Figure 1
Classification of indocyanine green angiography (ICGA) findings at baseline. The ICGA findings before PDT was applied to overlying areas of RPE leakage on FA, ICGA findings during the middle phase were classified as intense or low hyperfluorescence. First row demonstrates intense hyperfluorescence (A, B, C, D) and second row demonstrates low hyperfluorescence (E, F, G, H). M iddle phase of fluorescein angiography (A, E), early phase of ICGA (B, F), middle phase of ICGA (C, G) and late phase of ICGA (D, H).
jkos-53-268-g001
Table 1
Clinical data in patients with CSC treated by low fluence PDT
jkos-53-268-i001

ICGA = indocyanine green angiography; PDT = photodynamic therapy with 25 J/cm2; BCVA = best corrected visual acuity; SRF = subretinal fluid; PED = pigment epithelium detachment.

*Grade 1 hypoperfusion by Michels et al.28

Table 2
Characteristic of ICGA findings in CSC and rates of resolution of fluid
jkos-53-268-i002

Values are presented as mean ± SD (range) or n (%).

ICGA = indocyanine green angiography; VA = best-corrected visual acuity in logarithm of the minimum angle of resolution; FA = fluorescein angiography.

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