Profile of verteporfin and its potential for the treatment of central serous chorioretinopathy

Abstract

Central serous chorioretinopathy (CSCR) is an idiopathic disorder characterized by serous retinal detachments associated with focal leakage on fluorescein angiography and pigment epithelial detachments. While the majority of cases improve spontaneously over several months, a significant subset of patients advance to a chronic recurrent form of the disease with diffuse pigment epitheliopathy, foveal atrophy, scarring, and permanent visual loss. Photodynamic therapy (PDT) with verteporfn has been extensively studied as a potential therapeutic option for chronic cases. Multiple prospective interventional studies have demonstrated the efficacy of PDT for CSCR with significant functional and anatomic improvements achieved. Refinement of the PDT protocol has subsequently been performed in an effort to minimize adverse effects. Anti-vascular endothelial growth factor (anti-VEGF) agents, such as bevacizumab, have been utilized in the treatment of CSCR. Recent advances in imaging and functional testing have shed further light on possible pathophysiologic mechanisms of disease and post treatment changes induced by PDT. While the body of evidence supports PDT as an efficacious and relatively safe treatment for CSCR, further evaluation of the long-term efficacy and safety of PDT, as well as protocol improvements are required.

Keywords: CSC; CSCR; photodynamic therapy; retinopathy.

Figure 1

41 year old male with history of chronic central serous chorioretinopathy. Notes: (A) fundus photograph, (B) fluorescein angiogram, (C) ICG angiogram, (D) pre-PDT OCT, and (E) post-PDT OCT showing near resolution 2 months later. Abbreviations: ICG, indocyanine green; OCT, optical coherence tomography; PDT, photodynamic therapy.