Ultra-widefield indocyanine green angiographic changes after photodynamic therapy in central serous chorioretinopathy. CERTAIN study report 3.

Abstract

Purpose: Venous overload choroidopathy (VOC), showing pachyvessels, choroidal intervortex venous anastomoses (CVA), asymmetric venous drainage (AVD), choroidal vascular hyperpermeability (CVH) and increased choroidal thickness (CT), is observed in the vast majority of central serous chorioretinopathy (CSC) patients based on ultra-widefield indocyanine green angiography (UWF ICGA). This report investigates how photodynamic therapy (PDT) alters signs of VOC.

Methods: The CERTAIN study is a monocentric, retrospective study on consecutive CSC patients who underwent UWF ICGA. For this report, patients who underwent UWF ICGA twice were included. Two independent graders assessed changes in pachyvessels, CVA, AVD, CT and CVH when comparing pre- and post-PDT images of treated and untreated eyes.

Results: In total, 38 eyes (19 patients) were included. Of those, 19 eyes had undergone PDT and 19 had not. PDT had no significant effect on pachyvessels, CVA, and AVD (all p > 0.05). Only CT (-51 ± 48 µm vs. 1 ± 43 µm, p = 0.006) and CVH within the PDT treatment area (79% vs. 0% reduced CVH, p < 0.0001) were significantly decreased in treated vs. untreated eyes.

Conclusion: PDT reduced CT and CVH within the treatment area while not significantly altering the overall choroidal vascular architecture associated with VOC.