Photodynamic therapy combined with antivascular endothelial growth factor treatment for recalcitrant chronic central serous chorioretinopathy

Masumi G Asahi,1 Andrew T Chon,1 Esmeralda Gallemore,1 Ron P Gallemore1,2 1Clinical Research Department, Retina Macula Institute, Torrance, CA, USA; 2Jules Stein Eye Institute, University of California, Los Angeles, CA, USA Purpose: To determine whether combination photodynamic therapy (PDT) and a...

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Autores principales:	Asahi MG, Chon AT, Gallemore E, Gallemore RP
Formato:	article
Lenguaje:	EN
Publicado:	Dove Medical Press 2017
Materias:	anti-VEGF chronic central serous chorioretinopathy combination photodynamic therapy recalcitrant Ophthalmology RE1-994
Acceso en línea:	https://doaj.org/article/011a56d74106480da1edcd0207cb6803
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spelling	oai:doaj.org-article:011a56d74106480da1edcd0207cb68032021-12-02T00:41:09ZPhotodynamic therapy combined with antivascular endothelial growth factor treatment for recalcitrant chronic central serous chorioretinopathy1177-5483https://doaj.org/article/011a56d74106480da1edcd0207cb68032017-11-01T00:00:00Zhttps://www.dovepress.com/photodynamic-therapy-combined-with-antivascular-endothelial-growth-fac-peer-reviewed-article-OPTHhttps://doaj.org/toc/1177-5483Masumi G Asahi,1 Andrew T Chon,1 Esmeralda Gallemore,1 Ron P Gallemore1,2 1Clinical Research Department, Retina Macula Institute, Torrance, CA, USA; 2Jules Stein Eye Institute, University of California, Los Angeles, CA, USA Purpose: To determine whether combination photodynamic therapy (PDT) and antivascular endothelial growth factor (VEGF) therapy is effective in the management of chronic central serous chorioretinopathy (CSC) recalcitrant to conventional therapy. Methods: This was a retrospective analysis of eight patients with chronic CSC unresponsive to topical nonsteroidal anti-inflammatory drugs, focal photocoagulation, anti-VEGF alone, or PDT alone. All patients were evaluated with a full ophthalmic examination, spectral-domain optical coherence tomography (OCT), fluorescein angiography (FA), and most with indocyanine green angiography (ICGA) followed by treatment with half-fluence PDT and intravitreal anti-VEGF injection (seven bevacizumab, one aflibercept). Patients were seen in follow-up 1 month after treatment. Results: All eight patients achieved complete resolution in subretinal fluid following combination treatment. Average duration of CSC prior to initiation of combination therapy was 7.5 months. Mean central macular thickness on OCT decreased significantly from 401.2±52.7 µm to 297.9±18.2 µm (p=0.0010) by 4 months after treatment (1.63±1.18 months). Seven of eight patients were followed up for an average of 13 months with no recurrence during that time. One case recurred at 8 months and was treated with repeat combination at that time. Frank choroidal neovascularization (CNV) was not identified in these cases on FA or ICGA studies. Eight of eight patients showed significant improvement in vision from a logMAR of 0.1125±0.099 to 0.0125±0.064 (p=0.019). Conclusion: Combination PDT and anti-VEGF is effective for chronic CSC which has failed conventional therapy. Associated CNV and/or inflammation may be reasons for greater success in patients treated with combination therapy. Keywords: anti-VEGF, chronic central serous chorioretinopathy, combination, photodynamic therapy, recalcitrantAsahi MGChon ATGallemore EGallemore RPDove Medical Pressarticleanti-VEGFchronic central serous chorioretinopathycombinationphotodynamic therapyrecalcitrantOphthalmologyRE1-994ENClinical Ophthalmology, Vol Volume 11, Pp 2051-2056 (2017)
institution	DOAJ
collection	DOAJ
language	EN
topic	anti-VEGF chronic central serous chorioretinopathy combination photodynamic therapy recalcitrant Ophthalmology RE1-994
spellingShingle	anti-VEGF chronic central serous chorioretinopathy combination photodynamic therapy recalcitrant Ophthalmology RE1-994 Asahi MG Chon AT Gallemore E Gallemore RP Photodynamic therapy combined with antivascular endothelial growth factor treatment for recalcitrant chronic central serous chorioretinopathy
description	Masumi G Asahi,1 Andrew T Chon,1 Esmeralda Gallemore,1 Ron P Gallemore1,2 1Clinical Research Department, Retina Macula Institute, Torrance, CA, USA; 2Jules Stein Eye Institute, University of California, Los Angeles, CA, USA Purpose: To determine whether combination photodynamic therapy (PDT) and antivascular endothelial growth factor (VEGF) therapy is effective in the management of chronic central serous chorioretinopathy (CSC) recalcitrant to conventional therapy. Methods: This was a retrospective analysis of eight patients with chronic CSC unresponsive to topical nonsteroidal anti-inflammatory drugs, focal photocoagulation, anti-VEGF alone, or PDT alone. All patients were evaluated with a full ophthalmic examination, spectral-domain optical coherence tomography (OCT), fluorescein angiography (FA), and most with indocyanine green angiography (ICGA) followed by treatment with half-fluence PDT and intravitreal anti-VEGF injection (seven bevacizumab, one aflibercept). Patients were seen in follow-up 1 month after treatment. Results: All eight patients achieved complete resolution in subretinal fluid following combination treatment. Average duration of CSC prior to initiation of combination therapy was 7.5 months. Mean central macular thickness on OCT decreased significantly from 401.2±52.7 µm to 297.9±18.2 µm (p=0.0010) by 4 months after treatment (1.63±1.18 months). Seven of eight patients were followed up for an average of 13 months with no recurrence during that time. One case recurred at 8 months and was treated with repeat combination at that time. Frank choroidal neovascularization (CNV) was not identified in these cases on FA or ICGA studies. Eight of eight patients showed significant improvement in vision from a logMAR of 0.1125±0.099 to 0.0125±0.064 (p=0.019). Conclusion: Combination PDT and anti-VEGF is effective for chronic CSC which has failed conventional therapy. Associated CNV and/or inflammation may be reasons for greater success in patients treated with combination therapy. Keywords: anti-VEGF, chronic central serous chorioretinopathy, combination, photodynamic therapy, recalcitrant
format	article
author	Asahi MG Chon AT Gallemore E Gallemore RP
author_facet	Asahi MG Chon AT Gallemore E Gallemore RP
author_sort	Asahi MG
title	Photodynamic therapy combined with antivascular endothelial growth factor treatment for recalcitrant chronic central serous chorioretinopathy
title_short	Photodynamic therapy combined with antivascular endothelial growth factor treatment for recalcitrant chronic central serous chorioretinopathy
title_full	Photodynamic therapy combined with antivascular endothelial growth factor treatment for recalcitrant chronic central serous chorioretinopathy
title_fullStr	Photodynamic therapy combined with antivascular endothelial growth factor treatment for recalcitrant chronic central serous chorioretinopathy
title_full_unstemmed	Photodynamic therapy combined with antivascular endothelial growth factor treatment for recalcitrant chronic central serous chorioretinopathy
title_sort	photodynamic therapy combined with antivascular endothelial growth factor treatment for recalcitrant chronic central serous chorioretinopathy
publisher	Dove Medical Press
publishDate	2017
url	https://doaj.org/article/011a56d74106480da1edcd0207cb6803
work_keys_str_mv	AT asahimg photodynamictherapycombinedwithantivascularendothelialgrowthfactortreatmentforrecalcitrantchroniccentralserouschorioretinopathy AT chonat photodynamictherapycombinedwithantivascularendothelialgrowthfactortreatmentforrecalcitrantchroniccentralserouschorioretinopathy AT gallemoree photodynamictherapycombinedwithantivascularendothelialgrowthfactortreatmentforrecalcitrantchroniccentralserouschorioretinopathy AT gallemorerp photodynamictherapycombinedwithantivascularendothelialgrowthfactortreatmentforrecalcitrantchroniccentralserouschorioretinopathy
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Photodynamic therapy combined with antivascular endothelial growth factor treatment for recalcitrant chronic central serous chorioretinopathy

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