Claudio Iovino1, Adrian Au2, Jay Chhablani3, Deepika C Parameswarappa3, Mohammed Abdul Rasheed3, Gilda Cennamo4, Giovanni Cennamo5, Daniela Montorio5, Allen C Ho6, David Xu6, Giuseppe Querques7, Enrico Borrelli7, Riccardo Sacconi7, Francesco Pichi8, Elizabeth Woodstock8, Srinivas R Sadda9, Giulia Corradetti9, Camiel J F Boon10, Elon H C van Dijk11, Anat Loewenstein12, Dinah Zur12, Sugiura Yoshimi13, K Bailey Freund13, Enrico Peiretti1, David Sarraf14. 1. Department of Surgical Sciences, Eye Clinic, University of Cagliari, Cagliari, Italy. 2. Retinal Disorders and Ophthalmic Genetics Division, Stein Eye Institute, University of California Los Angeles, Los Angeles, California, United States. 3. Smt. Kanuri Santhamma Centre for Vitreo-Retinal Diseases, L V Prasad Eye Institute, Hyderabad, Telangana, India. 4. Eye Clinic, Public Health Department, University of Naples Federico II, Naples, Italy. 5. Department of Neurosciences, Reproductive Sciences and Dentistry, University of Naples Federico II, Naples, Italy. 6. Retina Service, Wills Eye Hospital, Philadelphia, Pennsylvania, USA. 7. Ophthalmology Department, San Raffaele University Hospital, Milan, Italy. 8. Cleveland Clinic Abu Dhabi, Eye Institute, Abu Dhabi, United Arab Emirates. 9. Doheny Eye Institute, UCLA, Los Angeles, California. 10. Department of Ophthalmology, Leiden University Medical Center, Leiden, the Netherlands; Department of Ophthalmology, Amsterdam University Medical Centers, Academic Medical Center, University of Amsterdam, Amsterdam, the Netherlands. 11. Department of Ophthalmology, Leiden University Medical Center, Leiden, the Netherlands. 12. Division of Ophthalmology, Tel Aviv Sourasky Medical Center affiliated to Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel. 13. Vitreous Retina Macula Consultants of New York, New York, New York. 14. Retinal Disorders and Ophthalmic Genetics Division, Stein Eye Institute, University of California Los Angeles, Los Angeles, California, United States; Greater Los Angeles VA Healthcare Center, Los Angeles CA. Electronic address: dsarraf@ucla.edu.
Abstract
PURPOSE: To study the early anatomical choroidal alterations in eyes with chronic central serous chorioretinopathy (CSCR) undergoing photodynamic therapy (PDT). DESIGN: Multicenter retrospective cohort study. METHODS: A total of 77 patients and 81 eyes with chronic CSCR treated with PDT and 64 untreated fellow eyes were evaluated. Central macular thickness (CMT), and choroidal features including subfoveal choroidal thickness (SFCT), total choroidal area (TCA), luminal choroidal area (LCA) and stromal choroidal area (SCA) were analyzed. Choroidal vascularity index (CVI) was calculated in all study eyes at baseline, and at 1- and 3-months post-PDT. RESULTS: In eyes receiving PDT, Snellen visual acuity (VA) significantly improved at months 1 and 3 (p<0.001). CMT and SFCT showed a significant reduction from baseline at months 1 and 3 (p<0.001), whereas TCA and LCA showed a significant decrease only at the 1-month follow up. Baseline mean TCA and LCA were 2.30 ± 1.41 mm2 and 1.23 ± 0.73 mm2, respectively, and decreased to 2.07 ± 1.21 mm2 and 1.08 ± 0.63 mm2 at the 1-month follow u p visit, respectively (p=0.01). No significant changes were recorded for SCA and CVI. In the fellow eye group, VA, CMT, and all choroidal parameters showed no differences between baseline and any follow up visits (all p>0.05). CONCLUSIONS: Following PDT for chronic CSCR, we observed sustained reductions in CMT and SFCT, while reductions in TCA and LCA were only noted at the 1-month follow up interval. These choroidal parameters may provide additional quantitative biomarkers to evaluate anatomical response to therapy but awaits further prospective validation.
PURPOSE: To study the early anatomical choroidal alterations in eyes with chronic central serous chorioretinopathy (CSCR) undergoing photodynamic therapy (PDT). DESIGN: Multicenter retrospective cohort study. METHODS: A total of 77 patients and 81 eyes with chronic CSCR treated with PDT and 64 untreated fellow eyes were evaluated. Central macular thickness (CMT), and choroidal features including subfoveal choroidal thickness (SFCT), total choroidal area (TCA), luminal choroidal area (LCA) and stromal choroidal area (SCA) were analyzed. Choroidal vascularity index (CVI) was calculated in all study eyes at baseline, and at 1- and 3-months post-PDT. RESULTS: In eyes receiving PDT, Snellen visual acuity (VA) significantly improved at months 1 and 3 (p<0.001). CMT and SFCT showed a significant reduction from baseline at months 1 and 3 (p<0.001), whereas TCA and LCA showed a significant decrease only at the 1-month follow up. Baseline mean TCA and LCA were 2.30 ± 1.41 mm2 and 1.23 ± 0.73 mm2, respectively, and decreased to 2.07 ± 1.21 mm2 and 1.08 ± 0.63 mm2 at the 1-month follow u p visit, respectively (p=0.01). No significant changes were recorded for SCA and CVI. In the fellow eye group, VA, CMT, and all choroidal parameters showed no differences between baseline and any follow up visits (all p>0.05). CONCLUSIONS: Following PDT for chronic CSCR, we observed sustained reductions in CMT and SFCT, while reductions in TCA and LCA were only noted at the 1-month follow up interval. These choroidal parameters may provide additional quantitative biomarkers to evaluate anatomical response to therapy but awaits further prospective validation.