Skip to main content

Advertisement

SpringerLink
Log in

Half-time photodynamic therapy in treatment of chronic central serous chorioretinopathy

  • Retinal Disorders
  • Published:
Graefe's Archive for Clinical and Experimental Ophthalmology Aims and scope Submit manuscript

Abstract

Purpose

Different modes of photodynamic therapy (PDT) were described for treatment of central serous chorioretinopathy (CSC). The purpose of the current study was to evaluate the outcome of half-time PDT in chronic CSC.

Methods

A retrospective case series study, including 114 eyes of 103 patients with chronic CSC, treated with reduced-fluence PDT. PDT was applied with full-dose verteporfin (6 mg/m2) and half-time fluence (43 s). The main outcome measures included timing of complete subretinal fluid (SRF) resolution, recurrences, pre- and post-treatment best-corrected visual acuities (BCVA). Anatomical and functional effects were compared in subgroup analysis on the basis of CSC treatment efficacy. Subsequent analysis was performed to compare eyes with and without recurrences and CSC eyes treated by single and multiple PDT sessions.

Results

A total of 114 eyes of 103 patients (81 male; 22 female) were analyzed. The median age was 49 (28–70). The median CSC pretreatment duration was 12 months (3–393). The median follow-up period after PDT was 8 months (6–111). By the sixth-month period PDT was effective in 80% (91 eyes), with a subsequent enhancement up to 87% (99 eyes) at 12th month and not effective in 13% (15 eyes). SRF resolution was achieved after 8 weeks (2–44) with a significant improvement of median LogMAR BCVA from 0.22 (− 0.2–1.3) before PDT to 0.1 (− 0.2–1.0) at last visit after PDT (p < 0.0001).

Conclusions

Half-time PDT has proven to be an effective and safe treatment option for patients with chronic CSC with a significant BCVA improvement during the follow-up after the therapy.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3

Similar content being viewed by others

References

  1. Gass JD (1967) Pathogenesis of disciform detachment of the neuroepithelium. Am J Ophthalmol 63(3 Suppl):1–139

    Google Scholar 

  2. Kitzmann AS, Pulido JS, Diehl NN et al (2008) The incidence of central serous chorioretinopathy in Olmsted County, Minnesota, 1980–2002. Ophthalmology 115:169–173

    Article  Google Scholar 

  3. Perkins SL, Kim JE, Pollack JS, Merrill PT (2002) Clinical characteristics of central serous chorioretinopathy in women. Ophthalmology 109(2):262–266

    Article  Google Scholar 

  4. Daruich A, Matet A, Dirani A et al (2015) Central serous chorioretinopathy: recent findings and new physiopathology hypothesis. Prog Retin Eye Res 48:82–118

    Article  CAS  Google Scholar 

  5. Bujarborua D (2001) Long-term follow-up of idiopathic central serous chorioretinopathy without laser. Acta Ophthalmol Scand 79:417–421

    Article  CAS  Google Scholar 

  6. Katsimpris JM, Pournaras CJ, Sehgelmeble CW, Petropoulos IK (2007) Severe bilateral central serous chorioretinopathy in a black patient: 16 years follow-up. Graefes Arch Clin Exp Ophthalmol 245:460–463

    Article  Google Scholar 

  7. Cardillo Piccolino F, Eandi CM, Ventre L, de la Longrais RC R, Grignolo FM (2003) Photodynamic therapy for chronic central serous chorioretinopathy. Retina 23(6):752–763

    Article  Google Scholar 

  8. Yannuzzi LA, Slakter JS, Gross NE, Spaide RF, Costa D, Huang SJ, Klancnik JM Jr, Aizman A (2003) Indocyanine green angiography-guided photodynamic therapy for treatment of chronic central serous chorioretinopathy: a pilot study. Retina 23(3):288–298

    Article  Google Scholar 

  9. Taban M, Boyer DS, Thomas EL, Taban M (2004) Chronic central serous chorioretinopathy: photodynamic therapy. Am J Ophthalmol 137(6):1073–1080

    Article  Google Scholar 

  10. Lim JI, Glassman AR, Aiello LP, Chakravarthy U, Flaxel CJ, Spaide RF (2014) Collaborative retrospective macula society study of photodynamic therapy for chronic central serous chorioretinopathy. Ophthalmology 121(5):1073–1078

    Article  Google Scholar 

  11. Reibaldi M, Cardascia N, Longo A et al (2010) Standard-fluence versus low-fluence photodynamic therapy in chronic central serous chorioretinopathy: a nonrandomized clinical trial. Am J Ophthalmol 149(2):307–315

    Article  Google Scholar 

  12. Liu HY, Yang CH, Yang CM, Ho TC, Lin CP, Hsieh YT (2016) Half-dose versus half-time photodynamic therapy for central serous chorioretinopathy. Am J Ophthalmol 167:57–64

    Article  Google Scholar 

  13. Tsai MJ, Hsieh YT (2014) Half-time photodynamic therapy for central serous chorioretinopathy. Optom Vis Sci 91(9):1140–1145

    Article  Google Scholar 

  14. Chan WM, Lam DS, Lai TY, Tam BS, Liu DT, Chan CK (2003) Choroidal vascular remodelling in central serous chorioretinopathy after indocyanine green guided photodynamic therapy with verteporfin: a novel treatment at the primary disease level. Br J Ophthalmol 87(12):1453–1458

    Article  Google Scholar 

  15. Reinke MH, Canakis C, Husain D, Michaud N, Flotte TJ, Gragoudas ES, Miller JW (1999) Verteporfin photodynamic therapy retreatment of normal retina and choroid in the cynomolgus monkey. Ophthalmology 106(10):1915–1923

    Article  CAS  Google Scholar 

  16. Schmidt-Erfurth U, Laqua H, Schlötzer-Schrehard U, Viestenz A, Naumann GO (2002) Histopathological changes following photodynamic therapy in human eyes. Arch Ophthalmol 120(6):835–844

    PubMed  Google Scholar 

  17. Schlötzer-Schrehardt U, Viestenz A, Naumann GO, Laqua H, Michels S, Schmidt-Erfurth U (2002) Dose-related structural effects of photodynamic therapy on choroidal and retinal structures of human eyes. Graefes Arch Clin Exp Ophthalmol 240(9):748–757

    Article  Google Scholar 

  18. Smretschnig E, Ansari-Shahrezaei S, Moussa S, Glittenberg C, Krebs I, Binder S (2012) Half-fluence photodynamic therapy in acute central serous chorioretinopathy. Retina 32(10):2014–2019

    Article  CAS  Google Scholar 

  19. Karakus SH, Basarir B, Pinarci EY, Kirandi EU, Demirok A (2013) A long-term results of half-dose photodynamic therapy for chronic central serous chorioretinopathy with contrast sensitivity changes. Eye (Lond) 227(5):612–620

    Article  Google Scholar 

  20. Valmaggia C, Haueter I, Niederberger H (2012) Photodynamic therapy in the treatment of persistent central serous chorioretinopathy: a two-year follow-up. Klin Monatsbl Augenheilkd 229(4):323–326

    Article  CAS  Google Scholar 

  21. Nicoló M, Eandi CM, Alovisi C, Grignolo FM, Traverso CE, Musetti D, Cardillo Piccolino F (2014) Half-fluence versus half-dose photodynamic therapy in chronic central serous chorioretinopathy. Am J Ophthalmol 157(5):1033–1037

    Article  Google Scholar 

  22. Alkin Z, Perente I, Ozkaya A, Alp D, Agca A, Aygit ED, Korkmaz S, Yazici AT, Demirok A (2014) Comparison of efficacy between low-fluence and half-dose verteporfin photodynamic therapy for chronic central serous chorioretinopathy. Clin Ophthalmol 5(8):685–690

    Article  Google Scholar 

  23. Fujita K, Imamura Y, Shinoda K, Matsumoto CS, Mizutani Y, Hashizume K, Mizota A, Yuzawa M (2015) One-year outcomes with half-dose verteporfin photodynamic therapy for chronic central serous chorioretinopathy. Ophthalmology 122(3):555–561

    Article  Google Scholar 

  24. Moon JW, Yu HG, Kim TW, Kim HC, Chung H (2009) Prognostic factors related to photodynamic therapy for central serous chorioretinopathy. Graefes Arch Clin Exp Ophthalmol 247(10):1315–1323

    Article  CAS  Google Scholar 

  25. Erikitola OC, Crosby-Nwaobi R, Lotery AJ, Sivaprasad S (2014) Photodynamic therapy for central serous chorioretinopathy. Eye 28:944–957

    Article  CAS  Google Scholar 

  26. Bonini Filho MA, de Carlo TE, Ferrara D, Adhi M, Baumal CR, Witkin AJ et al (2015) Association of choroidal neovascularization and central serous chorioretinopathy with optical coherence tomography angiography. JAMA Ophthalmol 133(8):899–906

    Article  Google Scholar 

  27. Cakir B, Reich M, Lang SJ, Bühler A, Stahl A, Böhringer D, Agostini H, Lange C (2017) Possibilities and limitations of OCT-angiography in patients with central serous chorioretinopathy. Klin Monatsbl Augenheilkd 234(9):1161–1168

    Article  CAS  Google Scholar 

  28. Berufsverband der Augenärzte Deutschlands e. V. (BVA); Deutsche Ophthalmologische Gesellschaft (DOG); Retinologische Gesellschaft (RG) e. V (2018) Statement and recommendation of the Professional Association of German Ophthalmologists (BVA), the German Ophthalmological Society (DOG) and the German retina society (RG) on central serous chorioretinopathy. Ophthalmologe 115(5):388–399

    Article  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Ophthalmology, University of Kiel, UKSH Campus Kiel, Arnold Heller str. 3, 24105, Kiel, Germany

    Vladimir Sheptulin, Konstantine Purtskhvanidze & Johann Roider

Authors
  1. Vladimir Sheptulin
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Konstantine Purtskhvanidze
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Johann Roider
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Vladimir Sheptulin.

Ethics declarations

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Informed consent

For this type of study, formal consent is not required.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Sheptulin, V., Purtskhvanidze, K. & Roider, J. Half-time photodynamic therapy in treatment of chronic central serous chorioretinopathy. Graefes Arch Clin Exp Ophthalmol 256, 2027–2034 (2018). https://doi.org/10.1007/s00417-018-4086-6

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00417-018-4086-6

Keywords

Search

Navigation