Isolated pigment epithelium detachment: evidence for relation to central serous chorioretinopathy and effect of photodynamic therapy

TY - JOUR

T1 - Isolated pigment epithelium detachment

T2 - evidence for relation to central serous chorioretinopathy and effect of photodynamic therapy

AU - Arif, Farah

AU - Pryds, Anders

AU - Larsen, Michael

N1 - © 2018 Acta Ophthalmologica Scandinavica Foundation. Published by John Wiley & Sons Ltd.

PY - 2018/12

Y1 - 2018/12

N2 - PURPOSE: To describe clinical characteristics and response to verteporfin therapy (PDT) in eyes with retinal pigment epithelium detachment (PED) in the absence of primary disease other than characteristics compatible with central serous chorioretinopathy (CSC).METHODS: Retrospective review of 634 consecutive patients diagnosed with isolated PED or CSC in one or both eyes in the period from 2007 to 2014 at a single institution.RESULTS: Pigment epithelium detachment (PED) in the absence of primary pathology other than angiographic choroidal hyperpermeability in the incident or fellow eye or manifest CSC in the fellow eye was found in 22 eyes in 19 patients. Follow-up ranged from 4 to 61 months. Five of 19 patients (26%) had classic CSC in the fellow eye. Transition from isolated PED to manifest CSC in the eye with PED was observed in seven eyes (33%) over a median untreated period of observation of 11 months (range, 1-32 months). A single session of PDT followed up 1-6 months later showed full resolution of the PED in seven (78%) of nine eyes. Of the 13 untreated eyes, five eyes (38%) underwent spontaneous resolution of the PED.CONCLUSION: Fellow-eye findings, conversion to CSC, resolution of PED after PDT or, less commonly, spontaneously support that isolated PED is a manifestation of CSC that represents an intermediate stage between pachychoroid and classic CSC. The chance of experiencing resolution of the PED was roughly twice as high with PDT as with untreated observation.

AB - PURPOSE: To describe clinical characteristics and response to verteporfin therapy (PDT) in eyes with retinal pigment epithelium detachment (PED) in the absence of primary disease other than characteristics compatible with central serous chorioretinopathy (CSC).METHODS: Retrospective review of 634 consecutive patients diagnosed with isolated PED or CSC in one or both eyes in the period from 2007 to 2014 at a single institution.RESULTS: Pigment epithelium detachment (PED) in the absence of primary pathology other than angiographic choroidal hyperpermeability in the incident or fellow eye or manifest CSC in the fellow eye was found in 22 eyes in 19 patients. Follow-up ranged from 4 to 61 months. Five of 19 patients (26%) had classic CSC in the fellow eye. Transition from isolated PED to manifest CSC in the eye with PED was observed in seven eyes (33%) over a median untreated period of observation of 11 months (range, 1-32 months). A single session of PDT followed up 1-6 months later showed full resolution of the PED in seven (78%) of nine eyes. Of the 13 untreated eyes, five eyes (38%) underwent spontaneous resolution of the PED.CONCLUSION: Fellow-eye findings, conversion to CSC, resolution of PED after PDT or, less commonly, spontaneously support that isolated PED is a manifestation of CSC that represents an intermediate stage between pachychoroid and classic CSC. The chance of experiencing resolution of the PED was roughly twice as high with PDT as with untreated observation.

KW - Adult

KW - Aged

KW - Central Serous Chorioretinopathy/complications

KW - Female

KW - Fluorescein Angiography

KW - Follow-Up Studies

KW - Fundus Oculi

KW - Humans

KW - Male

KW - Middle Aged

KW - Photochemotherapy/methods

KW - Photosensitizing Agents/therapeutic use

KW - Retinal Detachment/diagnosis

KW - Retinal Pigment Epithelium/drug effects

KW - Retrospective Studies

KW - Tomography, Optical Coherence

KW - Treatment Outcome

KW - Verteporfin/therapeutic use

KW - Visual Acuity

U2 - 10.1111/aos.13838

DO - 10.1111/aos.13838

M3 - Journal article

C2 - 30246489

SN - 1755-375X

VL - 96

SP - 821

EP - 827

JO - Acta Ophthalmologica

JF - Acta Ophthalmologica

IS - 8

ER -