Purpose:

To analyse the influence of chronicity and recurrence in structural and functional outcomes in central serous chorioretinopathy (CSC) patients who had half-dose photodynamic therapy (PDT), and to determine the characteristics of patients that recurred after treatment.

Methods:

A retrospective, observational study included treatment-naïve patients with CSC who received half-dose PDT. Measurements of best-corrected visual acuity (BCVA), central macular thickness (CMT) using OCT and retinal sensitivity (RS) assessed by microperimetry were registered. A sub-analysis was performed considering both chronicity and recurrence.

Results:

Eighty-four eyes of 73 patients were included in this study. Chronicity versus no-chronicity signs: 57 eyes had chronicity signs and 22.8% of those had at least one recurrence. Recurrence was significantly higher in the chronicity group (p=0.031, Fisher exact test). The chronicity group of patients also proved to be significantly older (p=0.009, Independent samples t test) and with baseline lower macular thickness (p=0.041, Mann-Whitney U test). A significant long-term improvement in BCVA, CMT and RS was consistently found in both groups (p<0.05) in all comparisons, Wilcoxon signed-rank test), however patients with chronicity signs presented worst visual outcomes (p<0.05 in all comparisons, Mann-Whitney U test). Recurrence versus no-recurrence: 14 eyes had recurrent episodes, and 92.9% of those had chronicity signs. Chronicity signs were far more frequent among the recurrent group (p=0.031, Fisher exact test). Recurrent patients presented with lower baseline CMT as well (p=0.017, Mann-Whitney U test). A significant long-term improvement was observed for all outcomes in patients without recurrences (p<0.05 in all comparisons, Wilcoxon signed-rank test) whereas in the recurrent group a significant improvement in BCVA was found only at the 3-months follow-up visit (p=0,009, Wilcoxon signed-rank test).

Conclusion:

Half-dose PDT is an effective and safe treatment for CSC. Nonetheless, patients with recurrence or chronicity signs presented worst functional and morphological outcomes, suggesting they should be treated earlier in order to avoid poorer results.

Contact Details:

Email: susanaapenas@gmail.com
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Susana Penas