Central Serous Retinopathy: Photodynamic Therapy Real-life Results


ABSTRACT

Introduction:

Central Serous Retinopathy (CSC) is a multifactorial pathology with a complex and non-totally clear pathogenesis. Most of them are auto limited with spontaneous resolution and a favourable prognosis. In some cases, serous macular detachment can remain or recur with progressive visual acuity loss. Photodynamic Therapy (PDT) based on half-dose or half-fluence is the most used treatment. Currently, some other therapies are being tested as antiangiogenic intravitreal injections or oral mineralocorticoid antagon ist like spironolactone.

Purpose:

Analyse our experience using PDT in chronic CSC since 2015 in Opthalmology Department, Hospital de Braga.

Material & Methods:

It was made a retrospective study in patients with chronic CSC submitted to PDT since January 2015 to March 2016. Demographic data included were sex and age. Ophthalmic examination included time of diagnosis, laterality, pre and post-treatment best-corrected visual acuity (BCVA) on letter count scale. All of them performed: Optical Coherence Tomography (OCT), Heidelberg, Spectralis – Macular Evaluation, Central Macular Thickness (CMT) and EDI with choroidal thickness evaluation, Indocianin Green Angiography (ICG) or Fluorescein Angiography (FA) – TRC-50DX Topcon.

Results:

68 patients were analysed. 23 were excluded due to lack of all data. 72.3% were male and mean age was 50,69±10 years. 10.6% were submitted to a bilateral treatment. Average time of disease until treatment was 13.4 months. PDT was made twice in 8.5% and three times in 6.4%. Mean BCVA was 74 and 79 pre and post-treatment. Pre and post-treatment CMT was 357,86±62µm and 278,47±23µm. Concomitant treatment with antiangiogenic intravitreal injection and/or spironolactone oral treatment was used in 43% of cases during first PDT, 73.4% who did it twice and 94.3% who did it three times. Favourable evolution was felt in 74.5% patients. 5 patients had a macular scar secondary to PDT.

Conclusions:

PDT is a therapeutic option for chronic CSC. Better prognosis maybe will be found when we associate treatment earlier and when we do not wait so much time until start it. Nevertheless, paquichoroidal diseases are not still well understood and maybe there is some pathophysiology not described yet. Anyway, PDT has favourable results and symptomatology improves in majority of patients.


CONTACT DETAILS

 

Keissy Sousa
Porto, Portugal
Email : keissy.sousa@gmail.com
Cell Phone: +351965227574
Work Phone: +351965227574