Comparison of efficacy between low-fluence and half-dose verteporfin photodynamic therapy for chronic central serous chorioretinopathy

Abstract

PurposeTo compare the efficacy of low-fluence photodynamic therapy (PDT) and PDT with half-dose verteporfin in chronic central serous chorioretinopathy (CSC).Patients and methodsThe medical records of 64 eyes from 60 patients with chronic CSC were retrospectively reviewed; 36 eyes received low-fluence PDT (25 J/cm2) and 28 eyes received half-dose verteporfin PDT (3 mg/m2). The primary outcome measure was the proportion of eyes with complete resolution of subretinal fluid. Secondary outcome measures were the changes in best corrected visual acuity (BCVA) and central foveal thickness, and the proportion of eyes that showed an increase of ≥5 letters in BCVA at the last visit.ResultsThe mean follow-up period was 12.5±4.3 months and 13.1±4 months in the low-fluence group and half-dose group, respectively (P=0.568). Thirty-three eyes (91.6%) in the low-fluence group and 26 eyes (92.8%) in the half-dose verteporfin group showed complete resolution of subretinal fluid (P=0.703). BCVA increased by a mean of 7.4 letters and 4.8 letters in the low-fluence group and half-dose group, respectively (P=0.336). Seventeen eyes (52.8%) in the low-fluence group and 14 eyes (50%) in the half-dose group experienced a gain of ≥5 letters in BCVA (P=0.825). In the low-fluence and half-dose verteporfin group, the mean baseline central foveal thickness was 351±90 μm and 341±96 μm, and significantly decreased to 188±61 μm and 181±47 μm, respectively (P<0.01).ConclusionBoth treatments resulted in complete subretinal fluid resolution in most of the eyes, with significantly better visual acuity outcomes compared to baseline at the last visit.

Long-term efficacy of half-dose photodynamic therapy on chronic central serous chorioretinopathy

“…Others used half-dose (3 mg/m 2 ), standard fluence PDT and had similar efficacy and reduced risk of complications 4–6 13. Recent reports comparing eyes receiving half-dose, standard fluence PDT versus eyes receiving half fluence, standard dose PDT showed either a comparable result14 or a better result for eyes receiving half-dose, standard fluence PDT 15…”

Comparison of Halving the Irradiation Time or the Verteporfin Dose in Photodynamic Therapy for Chronic Central Serous Chorioretinopathy

“…Alkin et al 20 reported that the resolution rates for SRF after both treatments were statistically equivalent (91.6% for low-fluence PDT and 92.8% for half-dose verteporfin PDT; P = 0.703). In conjunction with our study, which has shown equivalent therapeutic effects for reduced irradiation time and reduced verteporfin dose PDT, it seems that these three protocols are equally effective.…”

Photodynamic therapy: current role in the treatment of chorioretinal conditions

“…14,15,53,54 There is limited evidence to compare these different vPDT protocols for CSC in the absence of randomised controlled trials. 44,[55][56][57][58] The current approach to management of CSC is largely empirical. There is good evidence that vPDT therapy is a useful treatment option, but published studies are limited by selection bias, lack of randomisation, small sample size, and short follow-up.…”