Abstract
Objectives
To investigate the relationship between photoreceptor layer (PRL) changes before half-dose photodynamic therapy (PDT) and functional and anatomic outcomes in central serous chorioretinopathy (CSC).
Methods
Baseline PRL changes were classified based on optical coherence tomography: (1) smooth PRL outer border without a foveal PRL defect; (2) smooth PRL outer border with a foveal PRL defect; (3) granulated PRL outer border and (4) scattered dots of PRL. The best-corrected visual acuity (BCVA), difference in the foveal outer nuclear layer (ONL) thickness between the CSC and normal contralateral eyes and ellipsoid zone (EZ) integrity 12 months after half-dose PDT were compared.
Results
In total, 132 patients were included. Group 4 eyes had rather poor BCVA (20/2000–20/400) with little improvement (P = 0.088) at 1 year following half-dose PDT. In the other groups, the mean BCVA improved significantly to 20/25 or better (all P < 0.001). Group 1 eyes had the smallest foveal ONL thickness reduction (−5.12 ± 6.89 μm) and intact EZs (33/33), whereas Group 4 eyes had the largest foveal ONL thickness reduction (−70.00 ± 7.87 μm) and disrupted EZs (4/4). Group 2 and Group 3 eyes behaved similarly: they both had notable foveal ONL thickness reductions (−19.21 ± 18.53 and −20.75 ± 17.62 μm, respectively), but usually continuous EZs (18/19 and 69/76, respectively).
Conclusions
The PRL change category before half-dose PDT was closely related to functional and anatomic outcomes. This information could aid clinicians to better determine the timing of treatment with half-dose PDT in CSC.
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Funding
This research was supported by the Science and Technology Commission of Shanghai Municipality (grant no. 18411965100), the National Key Research and Development Plan (grant no. 2017YFC0108200) and the National Natural Science Foundation of China (grant no. 81900867).
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QC and CJ designed the study. XY and LL performed the photodynamic therapy. JY, XY and LL collected the data. JY, QC and CJ analysed and interpreted the data. JY was a major contributor in writing the manuscript. XY and LL participated in drafting the manuscript. QC and CJ revised the manuscript. All authors read and approved the final manuscript.
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Yu, J., Ye, X., Li, L. et al. Relationship between photoreceptor layer changes before half-dose photodynamic therapy and functional and anatomic outcomes in central serous chorioretinopathy. Eye 35, 1002–1010 (2021). https://doi.org/10.1038/s41433-020-1018-6
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DOI: https://doi.org/10.1038/s41433-020-1018-6
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