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INSTRUMENTAL DIFFERENCE IN ASSESSING CHOROIDAL HYPERPERMEABILITY AND PHOTODYNAMIC THERAPY IN CHRONIC CENTRAL SEROUS CHORIORETINOPATHY

Lee, Seung, Min, MD*; Kwon, Han, Jo, MD; Park, Sung, Who, MD†,‡; Lee, Ji, Eun, MD, PhD†,‡; Byon, Ik, Soo, MD, PhD*,‡

doi: 10.1097/IAE.0000000000002150
Original Study: PDF Only

Purpose: To investigate the difference in choroidal hyperpermeability (CH) assessed using digital fundus camera (DFC) and scanning laser ophthalmoscope (SLO) and its effect on photodynamic therapy (PDT) outcomes in chronic central serous chorioretinopathy.

Methods: Midphase indocyanine green angiography (ICGA) images were acquired using both DFC and SLO in 38 consecutive eyes with chronic central serous chorioretinopathy in this retrospective study. Scanning laser ophthalmoscope-ICGA was taken immediately after DFC-ICGA. Photodynamic therapy was applied to the area of CH associated with subretinal fluid (CH-SRF). The main outcome measures included the areas of CH in the macula and CH-SRF, resolution of SRF, and change in the best-corrected visual acuity.

Results: Areas of CH (5.187 ± 2.625 mm2 vs. 3.170 ± 1.661 mm2, P < 0.001) and CH-SRF (2.315 ± 1.111 mm2 vs. 1.465 ± 0.709 mm2, P < 0.001) were greater in DFC than in SLO. Sixteen eyes underwent DFC ICGA-guided PDT (DFC-PDT group) and 22 underwent SLO ICGA-guided PDT (SLO-PDT group). Subretinal fluid resolution at 12 months was 100.0% and 90.9% in the DFC-PDT and SLO-PDT groups, respectively, without statistical differences. The improvement of best-corrected visual acuity was earlier in the SLO-PDT group than in the DFC-PDT group (3 months, P = 0.002 vs. 6 months, P = 0.003), but the final best-corrected visual acuity showed no difference.

Conclusion: In chronic central serous chorioretinopathy, larger areas of CH and CH-SRF were observed with DFC than with SLO, which caused the ophthalmologists performing ICGA-guided PDT to determine a larger laser spot. This seemed to affect the time of visual recovery, but not the final outcome.

We identified that the choroidal hyperpermeability was larger in fundus camera indocyanine green angiography than in scanning laser ophthalmoscope indocyanine green angiography in same eye with chronic central serous chorioretinopathy, which influenced the diameter of laser spot and the time of visual recovery in photodynamic therapy.

*Department of Ophthalmology, Research Institute for Convergence of Biomedical Science and Technology, Pusan National University Yangsan Hospital, Yangsan, South Korea;

Department of Ophthalmology, Medical Research Institute, Pusan National University Hospital, Busan, South Korea; and

Pusan National University School of Medicine, Yangsan, South Korea.

Reprint requests: Ik Soo Byon, MD, PhD, Department of Ophthalmology, Pusan National University Yangsan Hospital, Pusan National University School of Medicine, Gumo-ro 20, Mulgum-eup, Yangsan-si, Gyeongsangnam-do 50612, South Korea; e-mail: isbyon@pusan.ac.kr

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

© 2018 by Ophthalmic Communications Society, Inc.