Comparing effects of photodynamic therapy in central serous chorioretinopathy: full-dose versus half-dose versus half-dose-half-fluence

Graefes Arch Clin Exp Ophthalmol. 2019 Oct;257(10):2155-2161. doi: 10.1007/s00417-019-04426-8. Epub 2019 Jul 31.

Abstract

Purpose: To compare the effects of full-dose, half-dose, and half-dose-half-fluence photodynamic therapy (PDT) in central serous chorioretinopathy (CSC).

Methods: This retrospective study enrolled patients with CSC who received full-dose (verteporfin 6 mg/m2), half-dose (verteporfin 3 mg/m2), and half-dose-half-fluence (verteporfin 3 mg/m2 and light energy reduced to 25 J/cm2) PDT. We measured visual acuity, subfoveal choroidal thickness (SFCT), subretinal fluid (SRF) thickness, and choroidal vascularity index (CVI) before and 3 months after PDT.

Results: Forty-three eyes (42 patients) were analyzed. Full-dose and half-dose groups showed improved vision (P = 0.023, 0.004, respectively), but half-dose-half-power group was not significantly improved (P = 0.254). SFCT in all three groups were significantly decreased (P = 0.005, 0.004, 0.002, respectively). SRF thicknesses in full-dose and half-dose groups showed significant decreases (P = 0.005, < 0.001, respectively). Half-dose-half-fluence group demonstrated the decrease but it was not statistically significant (P = 0.084). CVI were decreased in full-dose and half-dose groups (all P = 0.005). However, in the half-dose-half-fluence group, CVI was increased (P = 0.003).

Conclusion: Full-dose and half-dose PDT were both effective in CSC treatment. Half-dose PDT can be considered to reduce complications. The effect of half-dose-half-fluence PDT was less clear than the other two protocols.

Keywords: Central serous chorioretinopathy; Choroidal thickness; Choroidal vascularity index; Enhanced depth imaging optical coherence tomography; Photodynamic therapy.

Publication types

  • Comparative Study

MeSH terms

  • Central Serous Chorioretinopathy / diagnosis
  • Central Serous Chorioretinopathy / drug therapy*
  • Choroid / pathology*
  • Dose-Response Relationship, Drug
  • Female
  • Follow-Up Studies
  • Humans
  • Male
  • Middle Aged
  • Photochemotherapy / methods*
  • Photosensitizing Agents / administration & dosage
  • Retina / pathology*
  • Retrospective Studies
  • Tomography, Optical Coherence / methods*
  • Treatment Outcome
  • Verteporfin / administration & dosage*
  • Visual Acuity*

Substances

  • Photosensitizing Agents
  • Verteporfin