Severe CSR ,Visudyne/PDT Round Two

[lorilee66]

You folks have been so helpful in the past.  I have another question.  I went for a follow-up visit with my retinologist after having Visudyne/PDT treatment for my persistant CSR symptoms.  The symptoms (wavy vision, vaseline-like haze and bad low-light vision) have not gotten any better, and now I am having an awful time reading.  The letters themselves are still sharp, but the "lines" of print won't stay still, so reviewing quotes and drawings is starting to make me sick if I have to look at something for more than an hour.  My retinologist has me scheduled for another angiography next week to see how the leaking is doing, and he said we may need to repeat the Visudyne procedure. Is there any value in repeating a procedure that did nothing that I can tell?  Would another round possibly do harm? Your input would be most appreciated.

[John C Hagan III, MD, FACS, FAAO]

The divergence of opinion is because both treatments are sometimes helpful and neither has established itself as the 'gold standard" remember that most case of CSR resolve spontaneously without treatment.

I would get a third opinion and then go with one of the two retina MDs that you feel most comfortable with.

JCH MD

[Suresh158]

I am having CSR for the last 18 months and atlast my retinologist suggested to go for avastin injectoin to slow down the inflamation.  On a second opinion, another retinologist comments that avastin injection is harmful and should go for PDT instead.   Whats your valuable opinion?

[John C Hagan III, MD, FACS, FAAO]

Visudyne is done for retinal and choroidal neovascular membranes. These can bleed and destroy the central part of the vision. If you have CNV they need to continue to be treated with visudyne or an injectable (avastin, lucentis) until they are gone and stay gone.

If you are not comfortable get a second opinion from another retina EYE MD.

Stopping treatment is almost always a big mistake.

JCH MD