The efficacy of half-dose photodynamic therapy for acute central serous chorioretinopathy by enhanced deep imaging of optical coherence tomography_Chinese Journal of Ocular Fundus Diseases

Authors：

Zhang Caiyun , Mao Jianbo ,  Shen Lijun , Shao Yirun , Lin Jingjing , Lao Jimeng , Zheng Zicheng , Liu Bowen

Eye Hospital Wenzhou Medical University, Hangzhou 310000, China;

Corresponding?author：

Shen Lijun, Email: slj@mail.eye.ac.cn

Keywords：

Central serous chorioretinopathy/therapy; Photochemotherapy; Tomography, optical coherence

DOI：

10.3760/cma.j.cn511434-20190704-00213

Video：

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Objective To observe the clinical efficacy of half-dose photodynamic therapy (PDT) in the treatment of acute central serous chorioretinopathy (CSC) by enhanced deep imaging-OCT (EDI-OCT).Methods A retrospective case study. From September 2015 to November 2018, 100 patients with acute CSC who received half-dose PDT in Hangzhou Branch of the Eye Optometry Hospital of Wenzhou Medical University were included in the study. Among 100 patients, 69 patients were males and 31 patients were females; the average age was 49.63±7.97 years; the average duration of disease was 2.19±0.71 months. All patients underwent BCVA, EDI-OCT, FFA, ICGA and other examinations. BCVA was used on the international standard visual acuity chart and converted to logMAR visual acuity records. Before treatment, the average logMAR BCVA was 0.29±0.19, the average macular foveal retinal thickness (CMT) was 370.59±134.98 μm, and the average macular subfoveal choroidal thickness (SFCT) was 366.93±86.95 μm. All patients were treated with half-dose PDT. We compared the changes of BCVA, CMT, SFCT, and subretinal fluid (SRF) of the eye before treatment and 2 weeks after treatment and 1, 3, and 6 months. Pearson correlation analysis method was used to analyze the correlation between BCVA and baseline BCVA, CMT, SFCT after 6 months of treatment.Results Six months after treatment, SRF was completely absorbed in 98 eyes, with an effective rate of 98.0%. Compared with before treatment, 2 weeks and 1, 3, and 6 months after treatment, the BCVA of the eye significantly increased (F=66.493, P＜0.001), and CMT and SFCT significantly decreased (F=134.625, 30.394; P＜0.001,＜0.001). The results of Pearson correlation analysis showed that BCVA was positively correlated with baseline BCVA 6 months after treatment (r=0.529, P＜0.001), and there was no significant correlation with CMT and SFCT. There were no serious complications related to treatment during the follow-up period.Conclusions Half-dose PDT can effectively increase BCVA in a short period of time for acute CSC. EDI-OCT can observe that CMT, SFCT and SRF absorption are significantly reduced after treatment.

Citation： Zhang Caiyun, Mao Jianbo, Shen Lijun, Shao Yirun, Lin Jingjing, Lao Jimeng, Zheng Zicheng, Liu Bowen. The efficacy of half-dose photodynamic therapy for acute central serous chorioretinopathy by enhanced deep imaging of optical coherence tomography. Chinese Journal of Ocular Fundus Diseases, 2020, 36(9): 702-706. doi: 10.3760/cma.j.cn511434-20190704-00213 Copy

1.	Daruich A, Matet A, Dirani A, et al. Central serous chorioretinopathy: recent findings and new physiopathology hypothesis[J]. Prog Retin Eye Res, 2015, 48: 82-118. DOI: 10.1016/j.preteyeres.2015.05.003.
2.	趙明威. 努力探索發病機制, 進一步提升治療水平: 中心性漿液性脈絡膜視網膜病變研究的現實與挑戰[J]. 中華眼底病雜志, 2011, 27(4): 305-308. DOI: 10.3760/cma.j.issn.1005-1015.2011.04.001.Zhao MW. The pathogenesis and the clinical management: the challenges of treatment of central serous chorioretinopathy faced in reality[J]. Chin J Ocul Fundus Dis, 2011, 27(4): 305-308. DOI: 10.3760/cma.j.issn.1005-1015.2011.04.001.
3.	Gass JD. Pathogenesis of disciform detachment of the neuroepithelium[J]. Am J Ophthalmol, 1967, 63(3): 1-139.
4.	Kim DY, Joe SG, Yang HS, et al. Subfoveal choroidal thickness changes in treated idiopathic central serous chorioretinopathy and their association with recurrence[J]. Retina, 2015, 35(9): 1867-1874. DOI: 10.1097/IAE.0000000000000557.
5.	Hagen S, Ansari-Shahrezaei S, Smretschnig E, et al. The effect of photodynamic therapy on macular sensitivity in eyes with acute central serous chorioretinopathy[J]. Graefe's Arch Clin Exp Ophthalmol, 2013, 251(4): 1081-1089. DOI: 10.1007/s00417-012-2139-9.
6.	Zhao M, Zhang F, Chen Y, et al. A 50% vs 30% dose of verteporfin (photodynamic therapy) for acute central serous chorioretinopathy: one-year results of a randomized clinical trial[J]. JAMA Ophthalmol, 2015, 133(3): 333-340. DOI: 10.1001/jamaophthalmol.2014.5312.
7.	Kim KS, Lee WK, Lee SB. Half-dose photodynamic therapy targeting the leakage point on the fluorescein angiography in acute central serous chorioretinopathy: a pilot study[J]. Am J Ophthalmol, 2014, 157(2): 366-373. DOI: 10.1016/j.ajo.2013.10.013.
8.	廖燕紅, 周宏建. 半劑量維替泊芬光動力療法治療纖維蛋白沉積為主的中心性漿液性脈絡膜視網膜病變二例[J]. 中華眼底病雜志, 2011, 27(3): 294-295. DOI: 10.3760/cma.j.issn.1005-1015.2011.03.029.Liao YH, Zhou HJ. Half-dose verteporfin photodynamic therapy for two cases of central serous chorioretinopathy with fibrin deposition[J]. Chin J Ocul Fundus Dis, 2011, 27(3): 294-295. DOI: 10.3760/cma.j.issn.1005-1015.2011.03.029.
9.	李鵬程, 盛雙燕, 彭沖, 等. 半劑量光動力療法治療慢性中心性漿液性脈絡膜視網膜病變[J]. 中華眼底病雜志, 2011, 27(4): 327-330. DOI: 10.3760/cma.j.issn.1005-1015.2011.04.006.Li PC, Sheng SY, Peng C, et al. Half-dose photodynamic therapy for chronic central serous chorioretinopathy[J]. Chin J Ocul Fundus Dis, 2011, 27(4): 327-330. DOI: 10.3760/cma.j.issn.1005-1015.2011.04.006.
10.	Razavi S, Souied EH, Cavallero E, et al. Assessment of choroidal topographic changes by swept source optical coherence tomography after photodynamic therapy for central serous chorioretinopathy[J]. Am J Ophthalmol, 2014, 157(4): 852-860. DOI: 10.1016/j.ajo.2013.12.029.
11.	van Rijssen TJ, van Dijk EHC, Yzer S, et al. Central serous chorioretinopathy: towards an evidence-based treatment guideline[J/OL]. Prog Retin Eye Res, 2019, 73: 100770[2019-07-15]. https://pubmed.ncbi.nlm.nih.gov/31319157/. DOI: 10.1016/j.preteyeres.2019.07.003.
12.	Zhao MW, Zhou P, Xiao HX, et al. Photodynamic therapy for acute central serous chorioretinopathy: the safe effective lowest dose of verteporfin[J]. Retina, 2009, 29(8): 1155-1161. DOI: 10.1097/IAE.0b013e3181a6c028.
13.	Chan WM, Lai TY, Lai RY, et al. Half-dose verteporfin photodynamic therapy for acute central serous chorioretinopathy: one-year results of a randomized controlled trial[J]. Ophthalmology, 2008, 115(10): 1756-1765. DOI: 10.1016/j.ophtha.2008.04.014.
14.	Gilbert CM, Owens SL, Smith PD, et al. Long-term follow-up of central serous chorioretinopathy[J]. Br J Ophthalmol, 1984, 68(11): 815-820. DOI: 10.1136/bjo.68.11.815.
15.	Leaver P, Williams C. Argon laser photocoagulation in the treatment of central serous retinopathy[J]. Br J Ophthalmol, 1979, 63(10): 674-677. DOI: 10.1136/bjo.63.10.674.
16.	畢燕龍, 榮翱, 李錦文. 微脈沖激光治療中心性漿液性脈絡膜視網膜病變的臨床療效[J]. 中華眼底病雜志, 2007, 23(1): 45-47.Bi YL, Rong A, Li JW. Therapeutic effect of micropulse photocoagulation on central serous chorioretinopathy[J]. Chin J Ocul Fundus Dis, 2007, 23(1): 45-47.

1. Daruich A, Matet A, Dirani A, et al. Central serous chorioretinopathy: recent findings and new physiopathology hypothesis[J]. Prog Retin Eye Res, 2015, 48: 82-118. DOI: 10.1016/j.preteyeres.2015.05.003.
2. 趙明威. 努力探索發病機制, 進一步提升治療水平: 中心性漿液性脈絡膜視網膜病變研究的現實與挑戰[J]. 中華眼底病雜志, 2011, 27(4): 305-308. DOI: 10.3760/cma.j.issn.1005-1015.2011.04.001.Zhao MW. The pathogenesis and the clinical management: the challenges of treatment of central serous chorioretinopathy faced in reality[J]. Chin J Ocul Fundus Dis, 2011, 27(4): 305-308. DOI: 10.3760/cma.j.issn.1005-1015.2011.04.001.
3. Gass JD. Pathogenesis of disciform detachment of the neuroepithelium[J]. Am J Ophthalmol, 1967, 63(3): 1-139.
4. Kim DY, Joe SG, Yang HS, et al. Subfoveal choroidal thickness changes in treated idiopathic central serous chorioretinopathy and their association with recurrence[J]. Retina, 2015, 35(9): 1867-1874. DOI: 10.1097/IAE.0000000000000557.
5. Hagen S, Ansari-Shahrezaei S, Smretschnig E, et al. The effect of photodynamic therapy on macular sensitivity in eyes with acute central serous chorioretinopathy[J]. Graefe's Arch Clin Exp Ophthalmol, 2013, 251(4): 1081-1089. DOI: 10.1007/s00417-012-2139-9.
6. Zhao M, Zhang F, Chen Y, et al. A 50% vs 30% dose of verteporfin (photodynamic therapy) for acute central serous chorioretinopathy: one-year results of a randomized clinical trial[J]. JAMA Ophthalmol, 2015, 133(3): 333-340. DOI: 10.1001/jamaophthalmol.2014.5312.
7. Kim KS, Lee WK, Lee SB. Half-dose photodynamic therapy targeting the leakage point on the fluorescein angiography in acute central serous chorioretinopathy: a pilot study[J]. Am J Ophthalmol, 2014, 157(2): 366-373. DOI: 10.1016/j.ajo.2013.10.013.
8. 廖燕紅, 周宏建. 半劑量維替泊芬光動力療法治療纖維蛋白沉積為主的中心性漿液性脈絡膜視網膜病變二例[J]. 中華眼底病雜志, 2011, 27(3): 294-295. DOI: 10.3760/cma.j.issn.1005-1015.2011.03.029.Liao YH, Zhou HJ. Half-dose verteporfin photodynamic therapy for two cases of central serous chorioretinopathy with fibrin deposition[J]. Chin J Ocul Fundus Dis, 2011, 27(3): 294-295. DOI: 10.3760/cma.j.issn.1005-1015.2011.03.029.
9. 李鵬程, 盛雙燕, 彭沖, 等. 半劑量光動力療法治療慢性中心性漿液性脈絡膜視網膜病變[J]. 中華眼底病雜志, 2011, 27(4): 327-330. DOI: 10.3760/cma.j.issn.1005-1015.2011.04.006.Li PC, Sheng SY, Peng C, et al. Half-dose photodynamic therapy for chronic central serous chorioretinopathy[J]. Chin J Ocul Fundus Dis, 2011, 27(4): 327-330. DOI: 10.3760/cma.j.issn.1005-1015.2011.04.006.
10. Razavi S, Souied EH, Cavallero E, et al. Assessment of choroidal topographic changes by swept source optical coherence tomography after photodynamic therapy for central serous chorioretinopathy[J]. Am J Ophthalmol, 2014, 157(4): 852-860. DOI: 10.1016/j.ajo.2013.12.029.
11. van Rijssen TJ, van Dijk EHC, Yzer S, et al. Central serous chorioretinopathy: towards an evidence-based treatment guideline[J/OL]. Prog Retin Eye Res, 2019, 73: 100770[2019-07-15]. https://pubmed.ncbi.nlm.nih.gov/31319157/. DOI: 10.1016/j.preteyeres.2019.07.003.
12. Zhao MW, Zhou P, Xiao HX, et al. Photodynamic therapy for acute central serous chorioretinopathy: the safe effective lowest dose of verteporfin[J]. Retina, 2009, 29(8): 1155-1161. DOI: 10.1097/IAE.0b013e3181a6c028.
13. Chan WM, Lai TY, Lai RY, et al. Half-dose verteporfin photodynamic therapy for acute central serous chorioretinopathy: one-year results of a randomized controlled trial[J]. Ophthalmology, 2008, 115(10): 1756-1765. DOI: 10.1016/j.ophtha.2008.04.014.
14. Gilbert CM, Owens SL, Smith PD, et al. Long-term follow-up of central serous chorioretinopathy[J]. Br J Ophthalmol, 1984, 68(11): 815-820. DOI: 10.1136/bjo.68.11.815.
15. Leaver P, Williams C. Argon laser photocoagulation in the treatment of central serous retinopathy[J]. Br J Ophthalmol, 1979, 63(10): 674-677. DOI: 10.1136/bjo.63.10.674.
16. 畢燕龍, 榮翱, 李錦文. 微脈沖激光治療中心性漿液性脈絡膜視網膜病變的臨床療效[J]. 中華眼底病雜志, 2007, 23(1): 45-47.Bi YL, Rong A, Li JW. Therapeutic effect of micropulse photocoagulation on central serous chorioretinopathy[J]. Chin J Ocul Fundus Dis, 2007, 23(1): 45-47.

Chinese Journal of Ocular Fundus Diseases

The efficacy of half-dose photodynamic therapy for acute central serous chorioretinopathy by enhanced deep imaging of optical coherence tomography

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