Structural and Functional Outcomes in Chronic Central Serous Chorioretinopathy Treated with Photodynamic Therapy

Abstract

Purpose: To study the retinal pigment epithelium (RPE) and retinal alterations in chronic central serous chorioretinopathy treated with photodynamic therapy, and its correlation with functional parameters such as best-corrected visual acuity (BCVA) and contrast sensitivity (CS).

Methods: Retrospective, noncomparative, consecutive evaluation by optical coherence tomography and its correlation with BCVA and CS in 31 eyes of 26 patients.

Results: In all affected patients, 88.5% were male with a mean age of 42.9 years. The right eye was involved in 64.5% of cases, bilateral in 19% and 73.9% were hyperopic (spherical refraction between 0 and +5.0 diopters). Of these cases, 51.5% had peri-RPE abnormalities, 17.3% hyperreflective substances at RPE, 19.4% RPE atrophy, 55.3% foveolar atrophy, 3.1% pigment epithelial detachment, 5.2% subretinal fluid persistence, 8.3% fibrin deposits, 68.4% photoreceptor inner and outer segment line interruption and 31.1% external limiting membrane interruption.

Conclusions: Time evolution and number of outbreaks were related to the decrease in foveal and chorodial thickness and in those with worse BCVA and CS. RPE abnormalities and atrophy were related to the age of onset of symptoms. Photoreceptor elongation has been correlated with poor BCVA and inner and outer segment line destructuring and interruption with poor CS.

Keywords: Central serous chorioretinopathy; Contrast sensitivity; Optical coherence tomography; Photochemotherapy; Visual acuity.

Fig. 1. (A) Affected eye best-corrected visual acuity (logarithm of the minimum angle of resolution). (B) Affected eye contrast sensitivity.

Fig. 2. (A) Case A with hyper-reflective substances visualized by optical coherence tomography (OCT). (B) Case B shows anatomic success objectified by OCT. (C) Case C, OCT demonstrates foveolar atrophy. (D) Case D, pigment epithelial detachment and inner and outer segment line interruption. T = temporal; N = nasal.