Pachychoroid-Related Pigment Epithelial Detachment Treated with Photodynamic Therapy

Area of Science:

• Ophthalmology
• Medical Imaging
• Retinal Diseases

Background:

• Pachychoroid pigment epitheliopathy (PPE) is a pachychoroid spectrum disease with increased choroidal thickness and isolated pigment epithelial detachment (PED).
• Efficacy of photodynamic therapy (PDT) for isolated PPE is not well-defined, with limited evidence from small case series.

Purpose of the Study:

• Characterize symptomatic pachychoroid-related PED.
• Evaluate anatomical and functional outcomes of half-dose PDT (hd-PDT).
• Analyze outcomes based on lesion localization and history of central serous chorioretinopathy (CSC).

Main Methods:

• Retrospective study of 34 eyes treated with hd-PDT.
• Categorization of PEDs as central or paramacular.
• Assessment of best-corrected visual acuity (BCVA) and OCT parameters (CST, MST, MV, SFCT, PED height) at baseline, 1, and 6 months.
• Treatment planning guided by ICGA and SD-OCT.

Main Results:

• Complete PED resorption in 73.5% of eyes by 6 months, with higher rates for central lesions.
• Significant BCVA improvement from 0.22 to 0.10 logMAR at 6 months, with greater gain in central lesions.
• Reduced CST, MST, MV, and PED height; stable SFCT. Younger age, shorter duration, smaller baseline volume, and absence of CSC history correlated with better outcomes.

Conclusions:

• hd-PDT demonstrates favorable anatomical and functional outcomes in symptomatic pachychoroid-related PED.
• Centrally located lesions and baseline disease severity influence treatment response.
• Further prospective studies are needed to confirm long-term efficacy and safety.