Details

Autor(en) / Beteiligte

• Mirshahi, Reza
• Naseripour, Masood
• Ghomashi, Atefeh
• Falavarjani, Khalil Ghasemi

Titel

Clinical predictive factors and imaging biomarkers of treatment response to half dose PDT in patients with chronic central serous chorioretinopathy

Ist Teil von

• Photodiagnosis and photodynamic therapy, 2024-08, Vol.48, p.104224, Article 104224

Ort / Verlag

Netherlands: Elsevier B.V

Erscheinungsjahr

2024

Quelle

Alma/SFX Local Collection

Beschreibungen/Notizen

• •Half-dose photodynamic therapy (HD-PDT) is the gold standard treatment of central serous chorioretinopathy (CSC).•HD-PDT has a success rate (defined as resolution of subretinal fluid) of 95 % in CSC.•82.2 % of patients with chronic CSC show early response (in 1 month) to PDT.•The delayed or non-response to PDT in chronic CSC patients is associated with no history of administration of systemic corticosteroids, no history of pretreatment with eplerenone or acetazolamide before PDT and presence of hyperreflective foci in baseline OCT images. To determine the clinical and imaging biomarkers of the response to half-dose photodynamic therapy (HD-PDT) in patients with central serous chorioretinopathy (CSC) Clinical records and baseline ophthalmic images of 67 chronic CSC patients who underwent HD-PDT were assessed. In addition to demographic data, optical coherence tomography (OCT), fluorescein angiography (FA) and fundus autofluorescence (FAF) images were analyzed for specific biomarkers. The patients were categorized to early responder and late responder based on the time needed for complete resolution of subretinal fluid after PDT (less than 1 month vs. more than 1 month). The baseline clinical and imaging biomarkers were compared between the two groups. Seventy-three eyes of 67 patients were included in the study. The mean response time to PDT was 1.63 ± 1.48 months with 82.2% (60/73) of eyes categorized as early responder. The mean response time to PDT in delayed-response group was 4.15±1.51 months. In multivariate analysis, delayed response to PDT was associated with lacking history of systemic corticosteroid consumption, lacking history of pretreatment with eplerenone or acetazolamide before PDT and presence of hyperreflective foci in baseline OCT images (all p values < 0.05). There was no association between final visual outcome and late response to PDT. The presence of inflammatory biomarkers such as hyperreflective foci in baseline OCT images might be indicative of resistance to PDT. Moreover, the effect of pretreatment with mineralocorticoid antagonist on the response to PDT in chronic CSC should be explored in future prospective studies.