PMC3265181_01
Fluorescein angiography of right eye demonstrating hyperfluorescence and leakage at level of RPE. White circle depicts the area of fundus treated with PDT (1.5 mm laser spot).
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Fluorescein angiography depicted leakage superonasal to the fovea at the level of the RPE with pooling into the neurosensory space (Figure 1). CSC, patient chose to proceed with treatment. Photodynamic therapy with verteporfin using 1.5 mm laser spot size, standard treatment parameters, and 83 seconds of duration was applied to juxtafoveal area of leakage as guided by FA. Care was taken to avoid directly treating the fovea (Figure 1).
OCT image of retina and choroid prior to treatment demonstrating neurosensory retinal detachment. Arrowheads mark outer boundary of choroid used to measure choroidal thickness.
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Spectral domain OCT using Cirrus HD-OCT (Carl Zeiss Meditec, Inc., Dublin, CA, JUSA) demonstrated a neurosensory detachment of the fovea (Figure 2).
Fundus photograph of OD demonstrating thickness of choroid in microns at each specific measured point both before and after treatment.
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Thickest area of choroid (648 microns) was under area of leakage as seen on FA (Figure 3). Mean (SD) posttreatment choroidal thickness measurements were 424 microns (27) at 3 mm temporal to fovea, 341 microns (21) at 1.5 mm temporal to fovea, 370 microns (81) under the fovea, 331 microns (54) at 1.5 mm nasal to fovea, and 171 microns (17) at 3 mm nasal to fovea (Figure 3). P < 0.01, P < 0.01, P < 0.04, P < 0.01) at each location, respectively, using the Mann-Whitney test (Figure 4). Point of prior greatest choroidal thickness (648 microns) decreased to 504 microns, but was still the point of greatest choroidal thickness (Figure 3).
Chart comparing thickness of choroid at 3 mm temporal to fovea, 1.5 mm temporal to fovea, under the fovea, 1.5 mm nasal to fovea, and 3 mm nasal to fovea before and after treatment with PDT. Error bars represent one standard deviation. At all points, there was a significant reduction in choroidal thickness (the Mann-Whitney test): ***P < 0.01, **P < 0.04.
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P < 0.01, P < 0.01, P < 0.04, P < 0.01) at each location, respectively, using the Mann-Whitney test (Figure 4). Point of prior greatest choroidal thickness (648 microns) decreased to 504 microns, but was still the point of greatest choroidal thickness (Figure 3).