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ANTI-VEGF THERAPY VERSUS PHOTODYNAMIC THERAPY IN THE TREATMENT OF CHOROIDAL NEOVASCULARIZATION SECONDARY TO CENTRAL SEROUS CHORIORETINOPATHY

Peiretti, Enrico, MD*; Caminiti, Giulia, MD*; Serra, Rita, MD*; Querques, Lea, MD; Pertile, Riccardo, PhD; Querques, Giuseppe, MD, PhD

doi: 10.1097/IAE.0000000000001750
Original Study: PDF Only

Purpose: To evaluate the efficacy of photodynamic therapy (PDT) compared with intravitreal vascular endothelial growth factor (VEGF) inhibitors alone or combined with PDT in the treatment of choroidal neovascularization (CNV) secondary to chronic central serous chorioretinopathy (CSCR).

Methods: Retrospective study of a consecutive series of 34 white patients (34 eyes) with angiographic evidence of choroidal neovascularization secondary to chronic central serous chorioretinopathy, divided into two groups followed for at least 12 months: 16 were treated with full fluence PDT (PDT group) and 18 with vascular endothelial growth factor inhibitors (intravitreal [IVT] group).

Results: In the PDT group, mean best-corrected visual acuity (BCVA) was 20/40 (0.30 ± 0.69 logMAR) at baseline and did not change after 12 months (20/40; 0.30 ± 0.49 logMAR [P = 0.49]). In the IVT group mean, best-corrected visual acuity was 20/40 (0.30 ± 0.69 logMAR) at baseline and also did not change at the 12-month follow-up (20/32; 0.20 ± 0.49 logMAR [P = 0.20]). There was no statistically significant difference between the two groups in terms of best-corrected visual acuity. A statistical significance difference was found in central macular thickness between the two groups with a better reduction of the thickening in the PDT group (P = 0.05); moreover, indocyanine green angiography analysis revealed that 50% of the polypoidal lesions were closed after PDT and 25% of the polypoidal lesions disappeared after anti–vascular endothelial growth factor therapy at 12-month follow-up.

Conclusion: PDT and IVT inhibitors alone or combined show similar clinical effects in chronic central serous chorioretinopathy eyes with choroidal neovascularization.

Chronic central serous chorioretinopathy is a disorder that may be associated with the presence of choroidal neovascularization that can be managed with anti–vascular endothelial growth factor or photodynamic therapy. At one year follow-up, patients with central serous chorioretinopathy complicated with choroidal neovascularization showed similar benefit in terms of visual acuity being treated with the two different strategies.

*Department of Surgical Sciences, Eye Clinic, University of Cagliari, Cagliari, Italy;

Department of Ophthalmology, IRCCS Ospedale San Raffaele, University Vita-Salute San Raffaele, Milan, Italy; and

Clinical and Evaluative Epidemiology Department, Trento Health Service, Trento, Italy.

Reprint requests: Giuseppe Querques, MD, PhD, Department of Ophthalmology, IRCCS Ospedale San Raffaele, University Vita-Salute San Raffaele, Via Olgettina 60, Milan 20132, Italy; e-mail: giuseppe.querques@hotmail.it

None of the authors has any financial/conflicting interests to disclose.

© 2018 by Ophthalmic Communications Society, Inc.