Foveal Serous Retinal Detachment with Inferior Staphyloma: Long-Term Treatment Response to Anti-VEGF and Photodynamic Therapy

Abstract

Purpose: To evaluate the treatment response and long-term prognosis of foveal serous retinal detachment (SRD) associated with inferior staphyloma to anti-vascular endothelial growth factor (anti-VEGF) treatment and photodynamic therapy (PDT). Materials and Methods: Treatment-na & iuml;ve patients who underwent >24 months of follow-up were included. We analyzed inter-visit changes in the foveal subretinal fluid (SRF) height after anti-VEGF treatment or PDT compared to no treatment and longterm prognosis of best-corrected visual acuity in choroidal neovascularization (CNV)-free patients. Results: Nineteen patients were enrolled, and the mean follow-up duration was 4.81 years. In 14 CNV-free patients, 11 received anti-VEGF injections, three patients underwent PDT, and two patients had both treatments. During the follow-up period, there were a total of 243 inter-visit events (88 injections and 155 observations without treatment). At the last visit of patients who received the treatment, complete resolution was more significantly achieved in the CNV group than in the CNV-free group (p=0.028). In CNV-free patients, visual acuity improved when complete resolution was achieved; otherwise, it generally decreased. After adjusting for confounding factors, analyses showed no statistically significant differences in inter-visit changes of foveal SRF height between the anti-VEGF treatment and no treatment cases (absolute value, rate, subgroup categorized as +/- 20% of change; p=0.733, p=0.916, p=0.277; respectively). All patients who underwent PDT did not show complete resolution or maintained improvement of SRF. Conclusion: Treatment with anti-VEGF and PDT do not seem to be effective for foveal SRD of CNV-free inferior staphyloma.