CHOROIDAL NEOVASCULARIZATION SECONDARY TO PHOTODYNAMIC THERAPY FOR CENTRAL SEROUS CHORIORETINOPATHY

PURPOSE To investigate the incidence, risk factors, and clinical outcomes of complicated choroidal neovascularization (CNV) after reduced-fluence photodynamic therapy (PDT) for central serous chorioretinopathy (CSC). METHODS This is a retrospective consecutive interventional study including 559 eyes from 520 patients treated by reduced-fluence PDT for CSC. The incidence of complicated CNV within 3 months after PDT was calculated. Baseline demographics and ocular findings were investigated to identify risk factors. The clinical course of complicated CNV was analyzed. RESULTS Seven cases experienced development of active CNV after PDT within 3 months with a median interval of 4 weeks (range, 2-12 weeks). The incidence was estimated as 1.25% (95% CI, 0.55-2.62%). Complicated CNV developed in 6 among 138 eyes (4.35%) with flat irregular pigment epithelial detachment (PED) and in 1 among 421 eyes (0.24%) without flat irregular PED (p<0.001, Fisher's exact test). The median best-corrected visual acuity recovered from 20/100 at the time of CNV development to 20/20 after anti-vascular endothelial growth factor (VEGF) injections (median, 3 times). CONCLUSION In about one percent, reduced-fluence PDT for CSC may be complicated by CNV, which can be well controlled with anti-VEGF injection. Flat irregular PED increases the risk of secondary CNV following PDT.

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