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Early versus delayed photodynamic therapy for chronic central serous chorioretinopathy

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Abstract

Purpose

Central serous chorioretinopathy (CSCR) patients are sometimes referred to Photodynamic Therapy (PDT) with very long-term disease. The purpose of this study was to analyze the results of PDT in CSCR eyes with long-standing disease.

Methods

The medical records of the patients that underwent PDT for CSCR between 2009 and 2019 were reviewed. Cases were divided into two groups based on the duration of disease before PDT treatment: early treatment (3 to 6 months) and delayed treatment (longer than 6 months). The treatment was defined as successful when the subfoveal fluid was absorbed during follow-up.

Results

The PDT treatment was successful in 76% and 77% of eyes in the early and delayed treatment groups, respectively. Both groups showed significant improvement in central retina measurements at the 3-months follow-up which persisted to the last follow-up visit. The visual acuity (VA) at baseline was significantly worse in the delayed treatment group (0.5 ± 0.26 vs. 0.3 ± 0.24, P = 0.042) and improved in both groups but remained low in the delayed treatment group during the study.

Conclusion

We suggest that if CSCR is not spontaneously improving over 3 months the patient should be offered PDT, to prevent VA loss from the long-term presence of subretinal fluid in the macula. PDT is not associated with loss of vision in eyes with chronic CSCR, and can be safely used in eyes with relatively good VA.

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Data availability

All authors contributed to the study conception and design. Material preparation, data collection and analysis were performed by Efrat Gur, Gabriel Katz and Ari Leshno. The first draft of the manuscript was written by Gabriel Katz and all authors commented on previous versions of the manuscript. All authors read and approved the final manuscript.

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Funding

No funding was received for conducting this study.

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Authors and Affiliations

  1. Ophthalomology Department, Sheba Medical Center, Tel Hashomer, Israel

    Gabriel Katz, Efrat Gur, Joseph Moisseiev & Ari Leshno

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  1. Gabriel Katz
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Correspondence to Gabriel Katz.

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All authors certify that they have no affiliations with or involvement in any organization or entity with any financial interest or non-financial conflict of interest in the subject matter or materials discussed in this manuscript.

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. The study was approved by the Bioethics Committee of Sheba Medical Center (No. 623-19-SMC).

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This was a retrospective study on electronic data. There was no intervention within the study; and therefore, informed consent was not required.

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Katz, G., Gur, E., Moisseiev, J. et al. Early versus delayed photodynamic therapy for chronic central serous chorioretinopathy. Int Ophthalmol 43, 4055–4065 (2023). https://doi.org/10.1007/s10792-023-02822-y

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