A Multicenter Study on the Long-term Outcomes of Half-dose Photodynamic Therapy in Chronic Central Serous Chorioretinopathy

Lai, Frank Hiu Ping; Ng, Danny Siu-Chun; Bakthavatsalam, Malini; Chan, Vesta C.K.; Young, Alvin L.; Luk, Franklin T.; Tsang, Chun Wai; Brelén, Mårten

doi:10.1016/j.ajo.2016.07.026

Cited by 77 publications

(51 citation statements)

References 39 publications

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“…Additionally, no significant NRT decrease was observed. Previous studies reported the long-term rate of SRF resolution to be between 91.7 and 100% [25-27]. The anatomic success rate in our study was comparable to these studies.…”

Section: Discussionsupporting

confidence: 88%

“…The anatomic success rate in our study was comparable to these studies. The recurrence rate of CSC after PDT was reported to be between 2 and 20% in other studies, with a mean follow-up period ranging from 25 to 80 months [25-28]. The relatively low recurrence rate in the current study may be attributable to a higher proportion of subjects with better preservation of RPE function or early treatment.…”

Section: Discussionmentioning

confidence: 45%

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Long-Term Outcomes of Full-Fluence and Half-Fluence Photodynamic Therapy for Chronic Central Serous Chorioretinopathy

Son

Kim

2018

Ophthalmologica

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Purpose: To evaluate the efficacy and safety of full-fluence photodynamic therapy (PDT) and half-fluence PDT in chronic central serous chorioretinopathy (CSC). Procedures: A retrospective review of CSC patients treated with full-fluence or half-fluence PDT for 12 months was performed. Best-corrected visual acuity (BCVA), central macular thickness (CMT), neural retinal thickness, subfoveal choroidal thickness (SFCT), resolution of subretinal fluid (SRF), and incidence of retinal pigment epithelium (RPE) atrophy at 12, 24, and 36 months were assessed. Results: Thirty-seven and 30 eyes received full-fluence and half-fluence PDT, respectively. The BCVA and CMT improved significantly in both the full-fluence and half-fluence groups at 36 months, without a significant difference between the groups. Both groups showed significant reductions in SFCT with full-fluence (416.8–316.8 µm) being better overall than half-fluence (409.7–349.1 µm, p = 0.002). All patients achieved complete resolution without recurrence after one PDT treatment per eye. A few cases of RPE atrophy occurred, which could be correlated to PDT in both groups during the follow-up. Conclusion: Both treatments were effective and safe in chronic CSC, with significant improvements in anatomic and visual parameters, without recurrence of SRF.

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Section: Discussionsupporting

confidence: 88%

Section: Discussionmentioning

confidence: 45%

Long-Term Outcomes of Full-Fluence and Half-Fluence Photodynamic Therapy for Chronic Central Serous Chorioretinopathy

Son

Kim

2018

Ophthalmologica

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“…Consistent with previous studies, the baseline BCVA was significantly associated with the posttreatment BCVA in chronic CSC patients managed with PDT [6, 7, 17]. Those with a baseline BCVA of ≤6/30 were significantly less likely to have a posttreatment BCVA of ≥6/12 on the Snellen chart.…”

Section: Discussionsupporting

confidence: 87%

“…Half-dose PDT has been shown to have non-inferior efficacy but enhanced safety [5]. In chronic CSC patients, half-dose PDT was able to achieve long-term stable visual acuity and resolution of subretinal detachment [6]. …”

Section: Introductionmentioning

confidence: 99%

Angiographic and Tomographic Prognostic Factors of Chronic Central Serous Chorioretinopathy Treated with Half-Dose Photodynamic Therapy

Chung

Chan

2018

Ophthalmologica

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Aims: To identify the angiographic and tomographic prognostic factors of chronic central serous chorioretinopathy (CSC) treated with half-dose photodynamic therapy (PDT). Methods: This is a consecutive series of 61 eyes with chronic CSC treated with half-dose PDT from January 1, 2009 to October 31, 2016. Results: The mean logMAR best-corrected visual acuity (BCVA) improved from 0.47 to 0.31 at 3 months (p < 0.001). From multivariate regression, the final BCVA was significantly associated with the baseline BCVA (p = 0.003), a diffuse hyperfluorescence pattern on indocyanine green angiography (ICGA) (p = 0.024), posttreatment shallow irregular pigment epithelium detachment (PED) (p = 0.022), and disruption of the ellipsoid zone (p = 0.007). A diffuse hyperfluorescence pattern on ICGA was associated with a 77.4 times risk of subretinal fluid persistence after treatment (p = 0.009). Conclusion: A poor baseline BCVA, diffuse hyperfluorescence ICGA pattern, shallow irregular PED, and disruption of the ellipsoid zone indicate poor prognosis.

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“…12 Sub threshold micropulse laser has been shown to achieve resolution without any visible damage which is a major advantage apart from simplicity of the procedure and less cost as compared to PDT. 13 Anti VEGF (Bevacizumab) helps in faster resolution of subretinal fluid with restoration of normal anatomy which may promote RPE healing.…”

Section: Discussionmentioning

confidence: 99%

Micropulse diode laser versus bevacizumab in chronic central serous chorioretinopathy: a pilot study

Khan

Joshi²,

Gupta

2017

Int J Clin Trials

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Background: Central serous chorioretinopathy (CSC) is an idiopathic condition with an illdefined aetiopathogenesis and no clearly effective treatment. The choice of treatment include thermal laser photocoagulation, photodynamic therapy (PDT), subthreshold micropulse laser and anti VEGF. Methods: In a prospective nonrandomized pilot trial we evaluated two of these modalities subthreshold micropulse laser treatment and intravitreal anti VEGF in 20 consecutive cases of non-resolving CSC of duration 3 to 6 months with vision below 6/12 treated with either Bevacizumab for leakage close to fovea or subthreshold micropulse 810 diode laser for extrafoveal leakage (10% duty cycle, 100 µ spot size) as seen on fluorescein angiography.Results: At 6 months follow up complete resolution was seen in 9/10 in laser and 6/10 in Avastin group. The mean visual acuity improved from Log MAR 0.61 ± 0.17 at baseline to Log MAR 0.07± 0.11 post treatment in laser group and from Log MAR 0.59 ± 0.17 to Log MAR 0.18 ± 0.09 in the Avastin group . Similarly mean central macular thickness decreased from 607 µ ± 162.1 to 206 µ ± 55 in laser group and from 601 µ ± 182 to 262 µ ± 75 in those receiving Avastin. Both visual outcome and resolution of serous detachment was better with Micropulse laser as compared to Bevacizumab. Conclusions: Micropulse diode laser treatment of CSC has higher rate of resolution and better visual outcome as compared to Bevacizumab injections.

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A Multicenter Study on the Long-term Outcomes of Half-dose Photodynamic Therapy in Chronic Central Serous Chorioretinopathy

Cited by 77 publications

References 39 publications

Long-Term Outcomes of Full-Fluence and Half-Fluence Photodynamic Therapy for Chronic Central Serous Chorioretinopathy

Long-Term Outcomes of Full-Fluence and Half-Fluence Photodynamic Therapy for Chronic Central Serous Chorioretinopathy

Angiographic and Tomographic Prognostic Factors of Chronic Central Serous Chorioretinopathy Treated with Half-Dose Photodynamic Therapy

Micropulse diode laser versus bevacizumab in chronic central serous chorioretinopathy: a pilot study

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