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Vascular and structural alterations of the choroid evaluated by optical coherence tomography angiography and optical coherence tomography after half-fluence photodynamic therapy in chronic central serous chorioretinopathy

  • Sibel DemirelEmail author
  • Gökçen Özcan
  • Özge Yanık
  • Figen Batıoğlu
  • Emin Özmert
Retinal Disorders

Abstract

Purpose

To concurrently evaluate the effect of half-fluence photodynamic therapy (hf PDT) on choriocapillaris (CC) perfusion and choroidal structure in chronic central serous chorioretinopathy (CSC).

Methods

This prospective study included 48 eyes of 41 patients with chronic CSC. Enhanced depth imaging optical coherence tomography and optical coherence tomography angiography (OCTA) images were analyzed. Choroidal area (CA), luminal area (LA), and stromal area (SA) were computed using Image J software.

Results

One month after hf-PDT, total CA decreased to 1.312 mm2 from 1.490 mm2 (p < 0.001), LA decreased to 0.981 mm2 from 1.097 mm2 (p < 0.001), and SA decreased to 0.331 mm2 from 0.393 mm2 (p < 0.001). In OCTA, the CC flow in the eyes with CSC (17.75 mm2) was statistically significantly lower than the fellow eyes (18.93 mm2) at the baseline visit (p < 0.001). After hf-PDT, the flow in the choriocapillaris statistically significantly increased to 18.81 mm2 at the first month (p = 0.02).

Conclusions

OCTA proves that after hf-PDT a significant increase in CC perfusion occurred at first month. The decrease of the luminal areas in enhanced depth imaging optical coherence tomography is mainly due to a decrease in large-caliber vessels, which indicates that hf-PDT has an effect on larger choroidal vessels and spares CC flow.

Keywords

Half-fluence photodynamic therapy Optical coherence tomography angiography Chronic central serous chorioretinopathy Choriocapillaris perfusion 

Notes

Compliance with ethical standards

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

Informed consent was obtained from all individual participants included in the study.

References

  1. 1.
    Piccolino FC, de la Longrais RR, Ravera G, Eandi CM, Ventre L, Abdollahi A, Manea M (2005) The foveal photoreceptor layer and visual acuity loss in central serous chorioretinopathy. Am J Ophthalmol 139:87–99.  https://doi.org/10.1016/j.ajo.2004.08.037 CrossRefGoogle Scholar
  2. 2.
    Wang MS, Sander B, Larsen M (2002) Retinal atrophy in idiopathic central serous chorioretinopathy. Am J Ophthalmol 133:787–793CrossRefGoogle Scholar
  3. 3.
    Levy J, Marcus M, Belfair N, Klemperer I, Lifshitz T (2005) Central serous chorioretinopathy in patients receiving systemic corticosteroid therapy. Can J Ophthalmol 40:217–221.  https://doi.org/10.1016/S0008-4182(05)80040-7 CrossRefGoogle Scholar
  4. 4.
    Pikkel J, Beiran I, Ophir A, Miller B (2002) Acetazolamide for central serous retinopathy. Ophthalmology 109:1723–1725CrossRefGoogle Scholar
  5. 5.
    Rabiolo A, Zucchiatti I, Marchese A, Baldin G, Sacconi R, Montorio D, Cicinelli MV, Querques L, Bandello F, Querques G, Medscape (2018) Multimodal retinal imaging in central serous chorioretinopathy treated with oral eplerenone or photodynamic therapy. Eye (Lond) 32:55–66.  https://doi.org/10.1038/eye.2017.290 CrossRefGoogle Scholar
  6. 6.
    Burumcek E, Mudun A, Karacorlu S, Arslan MO (1997) Laser photocoagulation for persistent central serous retinopathy: results of long-term follow-up. Ophthalmology 104:616–622CrossRefGoogle Scholar
  7. 7.
    Bae SH, Heo JW, Kim C, Kim TW, Lee JY, Song SJ, Park TK, Moon SW, Chung H (2011) A randomized pilot study of low-fluence photodynamic therapy versus intravitreal ranibizumab for chronic central serous chorioretinopathy. Am J Ophthalmol 152:784–792 e782.  https://doi.org/10.1016/j.ajo.2011.04.008 CrossRefGoogle Scholar
  8. 8.
    Ozmert E, Batioglu F (2009) Fundus autofluorescence before and after photodynamic therapy for chronic central serous chorioretinopathy. Ophthalmologica 223:263–268.  https://doi.org/10.1159/000210386.000210386 CrossRefGoogle Scholar
  9. 9.
    Lim JW, Ryu SJ, Shin MC (2010) The effect of intravitreal bevacizumab in patients with acute central serous chorioretinopathy. Korean J Ophthalmol 24:155–158.  https://doi.org/10.3341/kjo.2010.24.3.155 CrossRefGoogle Scholar
  10. 10.
    Salehi M, Wenick AS, Law HA, Evans JR, Gehlbach P (2015) Interventions for central serous chorioretinopathy: a network meta-analysis. Cochrane Database Syst Rev CD011841.  https://doi.org/10.1002/14651858.CD011841.pub2
  11. 11.
    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 8:685–690.  https://doi.org/10.2147/OPTH.S58617.opth-8-685 CrossRefGoogle Scholar
  12. 12.
    Silva RM, Ruiz-Moreno JM, Gomez-Ulla F, Montero JA, Gregorio T, Cachulo ML, Pires IA, Cunha-Vaz JG, Murta JN (2013) Photodynamic therapy for chronic central serous chorioretinopathy: a 4-year follow-up study. Retina 33:309–315.  https://doi.org/10.1097/IAE.0b013e3182670fbe CrossRefGoogle Scholar
  13. 13.
    Cardillo Piccolino F, Eandi CM, Ventre L, Rigault de la Longrais RC, Grignolo FM (2003) Photodynamic therapy for chronic central serous chorioretinopathy. Retina 23:752–763CrossRefGoogle Scholar
  14. 14.
    Colucciello M (2006) Choroidal neovascularization complicating photodynamic therapy for central serous retinopathy. Retina 26:239–242CrossRefGoogle Scholar
  15. 15.
    Chan WM, Lai TY, Lai RY, Liu DT, Lam DS (2008) Half-dose verteporfin photodynamic therapy for acute central serous chorioretinopathy: one-year results of a randomized controlled trial. Ophthalmology 115:1756–1765.  https://doi.org/10.1016/j.ophtha.2008.04.014.S0161-6420(08)00373-4 CrossRefGoogle Scholar
  16. 16.
    Reibaldi M, Boscia F, Avitabile T, Russo A, Cannemi V, Uva MG, Reibaldi A (2009) Low-fluence photodynamic therapy in longstanding chronic central serous chorioretinopathy with foveal and gravitational atrophy. Eur J Ophthalmol 19:154–158CrossRefGoogle Scholar
  17. 17.
    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 87:1453–1458CrossRefGoogle Scholar
  18. 18.
    Taban M, Boyer DS, Thomas EL (2004) Chronic central serous chorioretinopathy: photodynamic therapy. Am J Ophthalmol 137:1073–1080.  https://doi.org/10.1016/j.ajo.2004.01.043.S000293940400087X CrossRefGoogle Scholar
  19. 19.
    Reibaldi M, Cardascia N, Longo A, Furino C, Avitabile T, Faro S, Sanfilippo M, Russo A, Uva MG, Munno F, Cannemi V, Zagari M, Boscia F (2010) Standard-fluence versus low-fluence photodynamic therapy in chronic central serous chorioretinopathy: a nonrandomized clinical trial. Am J Ophthalmol 149:307–315 e302.  https://doi.org/10.1016/j.ajo.2009.08.026 CrossRefGoogle Scholar
  20. 20.
    Schlotzer-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 240:748–757.  https://doi.org/10.1007/s00417-002-0517-4 CrossRefGoogle Scholar
  21. 21.
    Bonini Filho MA, de Carlo TE, Ferrara D, Adhi M, Baumal CR, Witkin AJ, Reichel E, Duker JS, Waheed NK (2015) Association of choroidal neovascularization and central serous chorioretinopathy with optical coherence tomography angiography. JAMA Ophthalmol 133:899–906.  https://doi.org/10.1001/jamaophthalmol.2015.1320 CrossRefGoogle Scholar
  22. 22.
    Chan SY, Wang Q, Wei WB, Jonas JB (2016) Optical coherence tomographic angiography in central serous chorioretinopathy. Retina 36:2051–2058.  https://doi.org/10.1097/IAE.0000000000001064 CrossRefGoogle Scholar
  23. 23.
    Quaranta-El Maftouhi M, El Maftouhi A, Eandi CM (2015) Chronic central serous chorioretinopathy imaged by optical coherence tomographic angiography. Am J Ophthalmol 160:581–587 e581.  https://doi.org/10.1016/j.ajo.2015.06.016 CrossRefGoogle Scholar
  24. 24.
    Demirel S, Yanik O, Nalci H, Batioglu F, Ozmert E (2017) The use of optical coherence tomography angiography in pachychoroid spectrum diseases: a concurrent comparison with dye angiography. Graefes Arch Clin Exp Ophthalmol 255:2317–2324.  https://doi.org/10.1007/s00417-017-3793-8 CrossRefGoogle Scholar
  25. 25.
    Chan WM, Lai TY, Lai RY, Tang EW, Liu DT, Lam DS (2008) Safety enhanced photodynamic therapy for chronic central serous chorioretinopathy: one-year results of a prospective study. Retina 28:85–93.  https://doi.org/10.1097/IAE.0b013e318156777f CrossRefGoogle Scholar
  26. 26.
    Cheng CK, Chang CK, Peng CH (2017) Comparison of photodynamic therapy using half-dose of verteporfin or half-fluence of laser light for the treatment of chronic central serous chorioretinopathy. Retina 37:325–333.  https://doi.org/10.1097/IAE.0000000000001138 CrossRefGoogle Scholar
  27. 27.
    Nicolo 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 157:1033–1037.  https://doi.org/10.1016/j.ajo.2014.01.022 CrossRefGoogle Scholar
  28. 28.
    Ozmert E, Demirel S, Yanik O, Batioglu F (2016) Low-fluence photodynamic therapy versus subthreshold micropulse yellow wavelength laser in the treatment of chronic central serous chorioretinopathy. J Ophthalmol 2016:3513794.  https://doi.org/10.1155/2016/3513794 CrossRefGoogle Scholar
  29. 29.
    Costanzo E, Cohen SY, Miere A, Querques G, Capuano V, Semoun O, El Ameen A, Oubraham H, Souied EH (2015) Optical coherence tomography angiography in central serous chorioretinopathy. J Ophthalmol 2015:134783.  https://doi.org/10.1155/2015/134783 Google Scholar
  30. 30.
    Demircan A, Yesilkaya C, Alkin Z (2018) Early choriocapillaris changes after half-fluence photodynamic therapy in chronic central serous chorioretinopathy evaluated by optical coherence tomography angiography: preliminary results. Photodiagn Photodyn Ther 21:375–378.  https://doi.org/10.1016/j.pdpdt.2018.01.015 CrossRefGoogle Scholar
  31. 31.
    Nassisi M, Lavia C, Alovisi C, Musso L, Eandi CM (2017) Short-term choriocapillaris changes in patients with central serous chorioretinopathy after half-dose photodynamic therapy. Int J Mol Sci 18.  https://doi.org/10.3390/ijms18112468

Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2019

Authors and Affiliations

  1. 1.Department of OphthalmologyAnkara University Faculty of Medicine AnkaraAnkaraTurkey
  2. 2.Alaaddin Keykubat University Alanya Education and Research HospitalAntalyaTurkey

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