Abstract
Background
Photodynamic therapy (PDT) has proven beneficial in the treatment of central serous chorioretinopathy (CSC).
Cases
Two patients with serous pigment epithelial detachments (PEDs) and one patient with chronic CSC developed an abrupt visual loss caused by severe choroidal ischemia following PDT. Serous PEDs in the two patients were regarded as a latent variant of CSC. PDT was performed in accordance with the Treatment of Age-Related Macular Degeneration with Photodynamic Therapy guidelines.
Observations
Although following PDT, PEDs and serous sensory retinal detachments resolved in all patients, the laser-treated areas of the patients revealed severe choroidal ischemia and their visual acuity decreased. Only in case 1 did visual acuity recover to the pretreatment level 2 months after treatment. In case 2, visual acuity was still reduced 7 months after treatment. In case 3, secondary choroidal neovascularization developed in the treatment area 1 month after treatment.
Conclusions
In the CSC variant associated with PED only or in chronic CSC, PDT performed by the standard procedure can increase the risk of severe choroidal ischemia. Further studies are needed to find safe and optimal PDT parameters.
References
Yannuzzi LA, Slakter JS, Gross NE, et al. Indocyanine green angiography-guided photodynamic therapy for treatment of chronic central serous chorioretinopathy: a pilot study. Retina 2003;23: 288–298.
Piccolino FC, Eandi CM, Ventre L, de la Longrais RCR, Grignolo FM. Photodynamic therapy for chronic central serous chorioretinopathy. Retina 2003;23:752–763.
Giovannini A, Scassellati-Sforzolini B, D’Altobrando E, Mariotti C, Rutili T, Tittarelli R. Choroidal findings in the course of idiopathic serous pigment epithelium detachment detected by indocyanine green videoangiography. Retina 1997;17:286–293.
Iida T, Kishi S, Hagimura N, Shimizu K. Persistent and bilateral choroidal vascular abnormalities in central serous chorioretinopathy. Retina 1999;19:508–512.
Lai TY, Chan WM, Li H, Lai RY, Liu DT, Lam DS. Safety enhanced photodynamic therapy with half dose verteporfin for chronic central serous chorioretinopathy: a short term pilot study. Br J Ophthalmol 2006;90:869–874.
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Lee, P.Y., Kim, K.S. & Lee, W.K. Severe choroidal ischemia following Photodynamic Therapy for pigment epithelial detachment and chronic central serous chorioretinopathy. Jpn J Ophthalmol 53, 52–56 (2009). https://doi.org/10.1007/s10384-008-0613-z
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DOI: https://doi.org/10.1007/s10384-008-0613-z