Central Serous Chorioretinopathy: Long-Term Results After Photodynamic Therapy
Autor(a) principal: | |
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Data de Publicação: | 2021 |
Outros Autores: | , , , , , , , , |
Tipo de documento: | Artigo |
Idioma: | eng |
Título da fonte: | Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) |
Texto Completo: | https://doi.org/10.48560/rspo.25892 |
Resumo: | Introduction: Central serous chorioretinopathy (CSC) is an idiopathic syndrome characterized by neurosensory detachments of the retina. Development of chronic CSC is an indication to treat, and ICGA-guided verteporfin photodynamic therapy has been shown to be very effective. Our objective was to evaluate the 13-year follow-up of chronic CSC patients treated with standard-fluence PDT and to explore the long-term microstructural and vascular choroidal changes related to the disease and treatment. Methods: Retrospective, interventional case-series analysis was conducted on 18 patients with cCSC, treated with standard PDT. Evaluations were performed every 3 months in the first year, every 6 months during the second year, and annually thereafter. All participants underwent a comprehensive ophthalmic examination. Retinal and choroidal imaging was performed with SD-OCT, SS-OCT, Optomap and OCTA. Results: Twenty-three eyes of eighteen patients were included, with a mean age of 63.9±8.5 years. The mean follow-up was 15.8±1.4 years. The mean number of sPDT treatments was 1.2±0.4. At baseline, subretinal fluid was found in all eyes, RPE proliferation in 9.1% and atrophy in 9.1% of the eyes. There was not a statistically significant improvement in BCVA, despite an initial mean gain of 5.08±10.36 letters at month 12 (p<0.05), which decreased to 1.87±11.9 letters at the end of follow-up. In the final visit, only 3 eyes present subretinal fluid, 3 had fibrosis, but 15 (65.2%) showed atrophy. Central macular thickness reduced from 340.7±114.9 µm to 228.7±38.6 µm at end of the follow-up. The choroid of treated eyes was thicker but the choriocapillaris had less vascular flow compared to fellow-nontreated eyes at this point. Only one session of sPDT was needed in the 19 eyes, and 4 underwent 2 sessions. Conclusion: ICGA-guided PDT full-fluence is a safe procedure, with no ocular or systemic adverse effects registered in our cohort. After 13 years, only 17.4% required 2 sessions. However, two-thirds of the cases presented atrophy in the last visit, which is probably related to the degenerative course of the disease and limited the initial visual acuity gains in the long term. |
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Central Serous Chorioretinopathy: Long-Term Results After Photodynamic TherapyCoriorretinopatia Serosa Central: Resultados a Longo Prazo Após Terapia FotodinâmicaArtigos OriginaisIntroduction: Central serous chorioretinopathy (CSC) is an idiopathic syndrome characterized by neurosensory detachments of the retina. Development of chronic CSC is an indication to treat, and ICGA-guided verteporfin photodynamic therapy has been shown to be very effective. Our objective was to evaluate the 13-year follow-up of chronic CSC patients treated with standard-fluence PDT and to explore the long-term microstructural and vascular choroidal changes related to the disease and treatment. Methods: Retrospective, interventional case-series analysis was conducted on 18 patients with cCSC, treated with standard PDT. Evaluations were performed every 3 months in the first year, every 6 months during the second year, and annually thereafter. All participants underwent a comprehensive ophthalmic examination. Retinal and choroidal imaging was performed with SD-OCT, SS-OCT, Optomap and OCTA. Results: Twenty-three eyes of eighteen patients were included, with a mean age of 63.9±8.5 years. The mean follow-up was 15.8±1.4 years. The mean number of sPDT treatments was 1.2±0.4. At baseline, subretinal fluid was found in all eyes, RPE proliferation in 9.1% and atrophy in 9.1% of the eyes. There was not a statistically significant improvement in BCVA, despite an initial mean gain of 5.08±10.36 letters at month 12 (p<0.05), which decreased to 1.87±11.9 letters at the end of follow-up. In the final visit, only 3 eyes present subretinal fluid, 3 had fibrosis, but 15 (65.2%) showed atrophy. Central macular thickness reduced from 340.7±114.9 µm to 228.7±38.6 µm at end of the follow-up. The choroid of treated eyes was thicker but the choriocapillaris had less vascular flow compared to fellow-nontreated eyes at this point. Only one session of sPDT was needed in the 19 eyes, and 4 underwent 2 sessions. Conclusion: ICGA-guided PDT full-fluence is a safe procedure, with no ocular or systemic adverse effects registered in our cohort. After 13 years, only 17.4% required 2 sessions. However, two-thirds of the cases presented atrophy in the last visit, which is probably related to the degenerative course of the disease and limited the initial visual acuity gains in the long term.Introdução: A coriorretinopatia serosa central (CSC) é uma síndrome idiopática caracterizada por descolamentos serosos da retina. O desenvolvimento de CSC crónica é uma indicação para tratamento e a terapia fotodinâmica com verteporfina guiada por ICGA tem-se revelado muito eficaz. O nosso objectivo foi avaliar a eficácia e segurança da TFD standard com verteporfina, durante um período de seguimento de 13 anos, descrevendo as alterações microestruturais e vasculares a longo prazo. Métodos: Procedeu-se a um estudo retrospetivo de doentes com CSC crónica, tratados com TFD standard. As avaliações periódicas foram realizadas a cada 3 meses no primeiro ano, cada 6 meses no segundo e, posteriormente, anualmente. Todos os participantes realizaram um exame oftalmológico completo. A imagiologia da retina e da coróide foi obtida recorrendo a abordagem multimodal com SD-OCT, SS-OCT, Optomap e OCTA. Resultados: Foram incluídos 23 olhos de 18 doentes, com uma idade média de 63,9±8,5 anos. O período médio de follow-up foi 15,8±1,4 anos. O número médio de tratamentos de TFDs foi de 1,2±1,4. No início do estudo, o fluído subretiniano estava presente em todos os olhos, a proliferação do EPR em 9,1% e atrofia em 9,1% dos olhos. Não se observou melhoria estatisticamente significativa na MAVC, apesar de um ganho médio inicial de 5,08±10,36 letras no 12º mês (p<0,05), que diminuiu para 1,87±11,9 letras no final do seguimento. Na visita final, apenas 3 olhos apresentavam fluído subretiniano, 3 demonstravam fibrose e 15 (65,2%) apresentavam atrofia. A espessura macular central reduziu de 340,7±114,9 µm para 228,7±38,6 no final do seguimento (p<0,05). A coróide dos olhos tratados era mais espessa, mas a coriocapilar apresentava menor fluxo vascular em comparação com olhos não tratados. Apenas uma sessão de TFDs foi necessária em 19 olhos e 4 realizaram duas sessões. Conclusão: A TFD standard guiada por ICGA é um procedimento seguro, sem efeitos adversos graves oculares ou sistémicos. Após 13 anos, apenas 17,4% dos casos necessitaram de 2 sessões. Porém, dois terços dos casos apresentaram atrofia na última consulta, o que provavelmente está relacionado com a progressão das alterações degenerativas da doença, limitando a melhoria da acuidade visual a longo prazo.Ajnet2021-12-31T00:00:00Zinfo:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/articlehttps://doi.org/10.48560/rspo.25892eng1646-69501646-6950Sousa Pereira, Pedro NunoFerreira, Sofia CatalãoSoares, MárioMelo, PedroFarinha, CláudiaMarques, João PedroPires, IsabelCachulo, Maria LuzMurta, JoaquimSilva, Rufinoinfo:eu-repo/semantics/openAccessreponame:Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)instname:Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informaçãoinstacron:RCAAP2022-09-22T17:06:17Zoai:ojs.revistas.rcaap.pt:article/25892Portal AgregadorONGhttps://www.rcaap.pt/oai/openaireopendoar:71602024-03-19T16:01:47.570974Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) - Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informaçãofalse |
dc.title.none.fl_str_mv |
Central Serous Chorioretinopathy: Long-Term Results After Photodynamic Therapy Coriorretinopatia Serosa Central: Resultados a Longo Prazo Após Terapia Fotodinâmica |
title |
Central Serous Chorioretinopathy: Long-Term Results After Photodynamic Therapy |
spellingShingle |
Central Serous Chorioretinopathy: Long-Term Results After Photodynamic Therapy Sousa Pereira, Pedro Nuno Artigos Originais |
title_short |
Central Serous Chorioretinopathy: Long-Term Results After Photodynamic Therapy |
title_full |
Central Serous Chorioretinopathy: Long-Term Results After Photodynamic Therapy |
title_fullStr |
Central Serous Chorioretinopathy: Long-Term Results After Photodynamic Therapy |
title_full_unstemmed |
Central Serous Chorioretinopathy: Long-Term Results After Photodynamic Therapy |
title_sort |
Central Serous Chorioretinopathy: Long-Term Results After Photodynamic Therapy |
author |
Sousa Pereira, Pedro Nuno |
author_facet |
Sousa Pereira, Pedro Nuno Ferreira, Sofia Catalão Soares, Mário Melo, Pedro Farinha, Cláudia Marques, João Pedro Pires, Isabel Cachulo, Maria Luz Murta, Joaquim Silva, Rufino |
author_role |
author |
author2 |
Ferreira, Sofia Catalão Soares, Mário Melo, Pedro Farinha, Cláudia Marques, João Pedro Pires, Isabel Cachulo, Maria Luz Murta, Joaquim Silva, Rufino |
author2_role |
author author author author author author author author author |
dc.contributor.author.fl_str_mv |
Sousa Pereira, Pedro Nuno Ferreira, Sofia Catalão Soares, Mário Melo, Pedro Farinha, Cláudia Marques, João Pedro Pires, Isabel Cachulo, Maria Luz Murta, Joaquim Silva, Rufino |
dc.subject.por.fl_str_mv |
Artigos Originais |
topic |
Artigos Originais |
description |
Introduction: Central serous chorioretinopathy (CSC) is an idiopathic syndrome characterized by neurosensory detachments of the retina. Development of chronic CSC is an indication to treat, and ICGA-guided verteporfin photodynamic therapy has been shown to be very effective. Our objective was to evaluate the 13-year follow-up of chronic CSC patients treated with standard-fluence PDT and to explore the long-term microstructural and vascular choroidal changes related to the disease and treatment. Methods: Retrospective, interventional case-series analysis was conducted on 18 patients with cCSC, treated with standard PDT. Evaluations were performed every 3 months in the first year, every 6 months during the second year, and annually thereafter. All participants underwent a comprehensive ophthalmic examination. Retinal and choroidal imaging was performed with SD-OCT, SS-OCT, Optomap and OCTA. Results: Twenty-three eyes of eighteen patients were included, with a mean age of 63.9±8.5 years. The mean follow-up was 15.8±1.4 years. The mean number of sPDT treatments was 1.2±0.4. At baseline, subretinal fluid was found in all eyes, RPE proliferation in 9.1% and atrophy in 9.1% of the eyes. There was not a statistically significant improvement in BCVA, despite an initial mean gain of 5.08±10.36 letters at month 12 (p<0.05), which decreased to 1.87±11.9 letters at the end of follow-up. In the final visit, only 3 eyes present subretinal fluid, 3 had fibrosis, but 15 (65.2%) showed atrophy. Central macular thickness reduced from 340.7±114.9 µm to 228.7±38.6 µm at end of the follow-up. The choroid of treated eyes was thicker but the choriocapillaris had less vascular flow compared to fellow-nontreated eyes at this point. Only one session of sPDT was needed in the 19 eyes, and 4 underwent 2 sessions. Conclusion: ICGA-guided PDT full-fluence is a safe procedure, with no ocular or systemic adverse effects registered in our cohort. After 13 years, only 17.4% required 2 sessions. However, two-thirds of the cases presented atrophy in the last visit, which is probably related to the degenerative course of the disease and limited the initial visual acuity gains in the long term. |
publishDate |
2021 |
dc.date.none.fl_str_mv |
2021-12-31T00:00:00Z |
dc.type.status.fl_str_mv |
info:eu-repo/semantics/publishedVersion |
dc.type.driver.fl_str_mv |
info:eu-repo/semantics/article |
format |
article |
status_str |
publishedVersion |
dc.identifier.uri.fl_str_mv |
https://doi.org/10.48560/rspo.25892 |
url |
https://doi.org/10.48560/rspo.25892 |
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eng |
language |
eng |
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1646-6950 1646-6950 |
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info:eu-repo/semantics/openAccess |
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openAccess |
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Ajnet |
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Ajnet |
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reponame:Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) instname:Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação instacron:RCAAP |
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Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação |
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RCAAP |
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RCAAP |
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Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) |
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Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) |
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Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) - Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação |
repository.mail.fl_str_mv |
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1799130483339034624 |