Título / Title

PDT AS A TREATMENT OPTION FOR SEROUS RETINAL DETACHMENT IN PATIENTS WITH DOME-SHAPED MACULOPATHY

Introdução / Purpose

To report a case of serous retinal detachment in a patient with dome-shaped macula (DSM) treated with photodynamic theraphy (PDT).

Material e Método / Methods

A 55 years old male patient complaint of progressive decrease vision in both eyes (OU). BCVA: 20/100 OU. Refraction: OD: -4,50 – 1,0 90o; OS: -3,50 – 1,00 90o. Wide-field angiography and optical coherence tomography (OCT) were required.

Resultados / Results

Fundus examination, OCT and wide-field angiography confirmed a dome-shaped maculopathy associated to serous retinal detachment in OU. Treatment was performed with full-fluence PDT in the OD and half-fluence in the OS. Two months after treatment, BCVA was 20/100 OU. Ancillary exams demonstrated resolution of serous retinal detachment in the OD and the presence of serous fluid in the OS. It was indicated Full-fluence PDT in OS, however the patient has not continued the treatment.

Discussão e Conclusões / Conclusion

An abnormal bending of the macula with increased choroidal and scleral thickening causing choroidal fluid outflow failure were the mechanism that causes the formation of subretinal fluid.

Treatment of serous retinal detachment in dome-shaped macula was not clearly defined. Treatment options include photodynamic therapy, focal laser photocoagulation, anti-angiogenic therapy and spironolactone.

As a treatment option, it was performed full-fluence PDT in the OD with satisfactory response. However, half-fluence was not enough to resolve subretinal fluid. This could be helpful to provide treatment alternatives for patients with serous retinal detachment in dome-shaped macula, however studies with larger number of patients are needed to confirm full-fluence PDT as first choice treatment for dome shape maculopathy.

Palavras Chave

myopia, PDT, dome-shaped, OCT, macula.

Area

CLINICAL RETINA