Photodynamic therapy for chronic central serous chorioretinopathy.

PURPOSE: This study aimed to evaluate the efficacy of photodynamic therapy (PDT) in treating chronic central serous chorioretinopathy (CSC). METHODS: We describe a non-randomized, multicentre, interventional case series. A total of 82 eyes of 72 patients with chronic CSC were treated by conventional PDT. LogMAR best corrected visual acuity (BCVA) (ETDRS charts) and central foveal thickness (CFT) measured by optical coherence tomography before and after PDT, number of PDT treatments and complications were used as outcome indicators. RESULTS: Mean follow-up was 12 +/- 10 months and mean age was 46 +/- 10 years. Mean logMAR BCVA changed from 0.53 (standard deviation [SD] 0.43) before PDT to 0.38 (SD 0.41) at 3 months and 0.48 (SD 0.50) at 6 months (p < 0.0001 and p = 0.007, respectively, Student's t-test for paired data). Mean BCVA at the end of follow-up was 0.37 (SD 0.45; p < 0.0001 from baseline). Macular detachment was resolved and subretinal fluid (SRF) disappeared in all cases. Central foveal thickness decreased from 325 microm (SD 95), to 229 microm (SD 70) at 1 month after PDT, 206 microm (SD 68) at 3 months, and 202 microm (SD 76) at 6 months (all p < 0.0001, Student's t-test for paired data). No cases developed severe visual loss or complications derived from PDT. Reactive retinal pigment epithelium hypertrophy appeared in nine cases after PDT. CONCLUSIONS: Photodynamic therapy with verteporfin may be useful in chronic CSC for improving BCVA and reducing SRF and CFT. Randomized studies with longer follow-up are needed to assess the real role of this treatment in chronic CSC.

Secondary elevated IOP and cataracts after high-dose intravitreal triamcinolone and photodynamic therapy to treat choroidal neovascularization.

PURPOSE: To analyze the appearance and evolution of high intraocular pressure (IOP) and cataracts after high-dose intravitreous triamcinolone acetonide (TA) and photodynamic therapy (PDT) to treat choroidal neovascularization associated with age-related macular degeneration. PATIENTS AND METHODS: Retrospective, consecutive, nonrandomized, interventional case series. Fifty-one consecutive eyes with subfoveal (all types) choroidal neovascularization associated to age-related macular degeneration were treated by PDT and intravitreal 19.4+/-2.1 mg/0.1 mL TA. Changes in IOP and lens were considered as primary outcome indicators. Optic disk changes were also considered. RESULTS: Twenty nine of 49 eyes (59%) needed topical therapy for high IOP at month 12, and 11 of 47 (23%) at month 24. Cataracts appeared in 14 of 42 phakic eyes (33%) after 12 months follow-up and in 22 of 40 phakic eyes (55%) completing 24 months follow-up. One eye showed an increased cup-to-disk ratio. CONCLUSIONS: The use of high-dose intravitreal TA is associated with cataracts and IOP elevation in approximately 50% of cases. The need for topical treatment for high IOP decreases during the second year.

The risk of retinal detachment in high myopia after small incision coaxial phacoemulsification.

PURPOSE: Report incidence and risk of retinal detachment (RD)after coaxial phacoemulsification in high myopic patients. DESIGN: Retrospective consecutive interventional study. SETTING: Vissum-Instituto Oftalmologico de Alicante, Spain. PATIENT OR STUDY POPULATION: A total of 439 eyes from 274 high myopic patients with spherical equivalent (SE) >or= 6.00 diopters (D) or axial length >or= 26.00 mm. Mean age 62.2, axial length 27.88 +/- 2.11 mm (26.0 mm to 37.9 mm), SE -13.3 +/- 5.6 (-6.00 D to -46.0 D). MAIN OUTCOME MEASURES: Incidence of RD, vitreous loss, and neodymium yttrium aluminum garnet (Nd:YAG) capsulotomy were evaluated after surgery at one, three, six, and 12 months then annually with mean follow-up 61.5 +/- 29.6 months. RESULTS: Incidence of RD was 2.7% (12/439 eyes). In eyes with 50 years of age was 2.52% (nine eyes). Cumulative risk of RD development by Kaplan-Meier analysis in all patients was 0.47%, 0.71%, 1.71%, 2.59%, and 3.28% at three, six, 15, 48, and 63 months until 105 months, respectively. In eyes 50 years of age was 0.58% and 2.96% at six and 52 months until 118 months after cataract surgery, respectively. No significant correlation was found between the occurrence of RD and vitreous loss (P