Half-Dose Verteporfin Photodynamic Therapy for Acute Central Serous Chorioretinopathy

Chan, Wai‐Man; Lai, Timothy Y. Y.; Lai, Robin Kit-Ho; Liu, David T.L.; Lam, Dennis S.C.

doi:10.1016/j.ophtha.2008.04.014

Cited by 280 publications

(205 citation statements)

References 36 publications

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“…However, in spite of little discrepancy in the protocol, the success rate (about 83.3%) at 1 month on CSC is comparable with the previous outcomes (75-96%) after PDT. 13,14,[17][18][19]23 Our results of decreased choroidal thickness following PDT concur with prior reports. 13,14,16 It resulted from the action mechanism of PDT.…”

Section: Discussionsupporting

confidence: 91%

“…4,5,[17][18][19] Generally, in lowfluence PDT, a laser light at 689 nm delivered 25 J/cm 2 with an intensity of 300 mW/cm 2 over 83 s. 17,19 Whereas, in our study, the same wavelength laser with 600 mW/ cm 2 intensity as the full dose PDT was applied for 50 s and total light energy (30 J/cm 2 ). However, in spite of little discrepancy in the protocol, the success rate (about 83.3%) at 1 month on CSC is comparable with the previous outcomes (75-96%) after PDT.…”

Section: Discussionmentioning

confidence: 74%

“…The discrepancy may also explain the reasons why the recurrence rate of CSC was relatively lower after PDT, which induced short-term occlusion of choriocapillary and long-term choroidal vascular remodeling. 13,14,17,18 The main limitation of this study is that the follow-up was relatively short. Because the visual impairment from CSC is not severe in general, patients did not visit the clinic after the disappearance of the symptoms.…”

Section: Discussionmentioning

confidence: 97%

“…To avoid the potential complications of conventional PDT, the patients had undergone a modified fluence PDT-reduced time of laser emission (50 s) and total light energy (30 J/cm 2 ), using the standard dose of verteporfin (6 mg/m 2 ) and laser intensity (600 mW/cm 2 ). 4,5,14,[17][18][19] The PDT spot size was determined by measuring the greatest linear dimension of the area of choroidal vascular hyperpermeability, corresponding to the origin of subfoveal fluid on ICGA. Patients receiving PDT were followed up and BCVA and SFCT using EDI-OCT at 7 day and 1 month after treatment were evaluated.…”

Section: Methodsmentioning

confidence: 99%

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Change in subfoveal choroidal thickness in central serous chorioretinopathy following spontaneous resolution and low-fluence photodynamic therapy

Kang

2013

Eye

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Purpose To assess the change in subfoveal choroidal thickness (SFCT) in central serous chorioretinopathy (CSC) following spontaneous resolution and low-fluence photodynamic therapy (PDT) using the enhanced depth imaging optical coherence tomography (EDI-OCT). Methods A total of 36 consecutive eyes of 36 patients were included in this retrospective study: 16 eyes with spontaneously resolved CSC and 20 eyes with PDT-treated CSC. Best-corrected visual acuity and SFCT were evaluated at each visit until complete absorption of the subretinal fluid. SFCT of 32 normal subjects were also measured, as the control group. Wilcoxon's singed-rank test was used to evaluate the effects of spontaneous resolution and PDT. To compare the SFCT of the eyes with resolved CSC with that of the normal eyes, Mann-Whitney U-test with Bonferroni correction was also employed. Results SFCT of patients was 459.16 ± 77.50 lm at the baseline, and decreased to 419.31±54.49lm after a spontaneous resolution (P ¼ 0.015). However, SFCT was not normalized in comparison with that of the normal subjects (Po0.001). SFCT in PDT group was also reduced from 416.43 ± 74.01 to 349.50 ± 88.99 lm (Po0.001), with no significant difference with the normal value (P ¼ 0.087).Conclusions SFCT in patients with CSC decreased both after spontaneous resolution and low-fluence PDT. However, only in the PDT group, after disappearance of subretinal fluid, did it decrease to that of normal subjects.

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Section: Discussionsupporting

confidence: 91%

Section: Discussionmentioning

confidence: 74%

Section: Discussionmentioning

confidence: 97%

Section: Methodsmentioning

confidence: 99%

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Change in subfoveal choroidal thickness in central serous chorioretinopathy following spontaneous resolution and low-fluence photodynamic therapy

Kang

2013

Eye

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“…[13][14][15]27,28 This less favorable outcome in our cohort is potentially attributed to the severity of the disease in our patients with often long-standing disease accompanied by chronic retinal and choroidal changes. More than 60% of our patients had a disease duration of 41 year.…”

Section: Discussionmentioning

confidence: 75%

Comparison of subthreshold micropulse laser (577 nm) treatment and half-dose photodynamic therapy in patients with chronic central serous chorioretinopathy

Scholz

Altay

Fauser

2016

Eye

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Purpose To compare the short-term treatment outcome of the 577 nm subthreshold micropulse laser (SML) and half-dose photodynamic therapy (PDT) in patients with chronic central serous chorioretinopathy (cCSC) and persistent subretinal fluid (SRF). Methods This retrospective study included 100 eyes of 100 consecutive patients who were treated with the 577 nm SML (Supra Scan, Quantel Medical) (n = 42) or half-dose PDT (n = 58) for cCSC. The treatment was applied at the leakage sites in the fluorescein and indocyanine green angiography. The treatment success was evaluated 6 weeks after treatment using best-corrected visual acuity, central retinal thickness, and resolution of SRF in spectral domain optical coherence tomography. Results Patients showed treatment response more often in the SML group compared with the PDT group (treatment response after SML: 33 eyes (79%), PDT: 34 eyes (59%), P = 0.036, χ 2 test). The CRT decreased significantly after both treatments (mean CRT before SML: 445 ± 153 μm, after SML: 297 ± 95, Po0.001; mean CRT before PDT: 398 ± 88 μm, after PDT: 322 ± 93 μm, Po0.001, Wilcoxon's signed-rank test). The decrease in CRT was statistically significantly higher in the SML group (decrease in CRT after SML: − 148 ± 163 μm, after PDT: − 76 ± 104 μm, P = 0.041, Mann-Whitney U-test). Conclusions Both the half-dose PDT and the 577 nm SML are potent treatments for cCSC with persistent SRF. More patients showed treatment response to the SML treatment and SML leads to a greater decrease in CRT.

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A 50% vs 30% Dose of Verteporfin (Photodynamic Therapy) for Acute Central Serous Chorioretinopathy

et al. 2015

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IMPORTANCE A randomized clinical trial is needed to evaluate what is the best photodynamic therapy (PDT) protocol to use for acute central serous chorioretinopathy.OBJECTIVE To compare the efficacy and safety of a 50% dose of verteporfin (a method of PDT) with the efficacy and safety of a 30% dose for acute central serous chorioretinopathy. DESIGN, SETTING, AND PARTICIPANTSA multicenter, noninferiority, double-masked, randomized, controlled, clinical trial in which 131 patients (131 eyes) with acute central serous chorioretinopathy for less than 6 months were recruited with a follow-up of 12 months from university-based ophthalmology practices.INTERVENTIONS Patients were randomly assigned to either a 50% dose of verteporfin (the 50%-dose PDT group) or a 30% dose (the 30%-dose PDT group). MAIN OUTCOMES AND MEASURESThe 2 primary outcome measures were the proportion of eyes with complete absorption of subretinal fluid and the proportion of eyes with complete disappearance of fluorescein leakage at 6 and 12 months. The secondary outcome measures included the subretinal fluid recurrent rate, the fluorescein leakage recurrent rate at 12 months, the mean best-corrected visual acuity, the retinal thickness of the foveal center, and the maximum retinal thickness at each scheduled visit. RESULTSThe noninferiority of the 30%-dose PDT compared with the 50%-dose PDT for the primary outcomes was not demonstrated. The optical coherence tomography-based improvement rate in the 30%-dose PDT group was less than that in the 50%-dose PDT group both at 6 months (73.8% vs 92.9%; α = 0.0125, P = .006) and at 12 months (75.4% vs 94.6%; α = 0.0125, P = .004). The fluorescein angiography-based improvement rate in the 30%-dose PDT group was less than that in the 50%-dose PDT group both at 6 months (68.9% vs 91.1%; α = 0.0125, P = .003) and at 12 months (68.9% vs 92.9%; α = 0.0125, P = .001). The subretinal fluid recurrence rate in the 30%-dose PDT group was greater than that in the 50%-dose PDT group (24.0% vs 5.7% at 12 months; P = .010, determined by use of the log-rank test). The fluorescein leakage recurrent rate in the 30%-dose PDT group was significantly higher than that in the 50%-dose PDT group (16.7% vs 3.8% at 12 months; P = .03, determined by use of the log-rank test). No ocular adverse event was encountered in the study. CONCLUSIONS AND RELEVANCEA 50% dose of verteporfin may be more effective at resolving subretinal fluid and fluorescein leakage, and with better visual outcomes, than a 30% dose for acute central serous chorioretinopathy. TRIAL REGISTRATION clinicaltrials.gov Identifier: NCT01574430

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Half-Dose Verteporfin Photodynamic Therapy for Acute Central Serous Chorioretinopathy

Cited by 280 publications

References 36 publications

Change in subfoveal choroidal thickness in central serous chorioretinopathy following spontaneous resolution and low-fluence photodynamic therapy

Change in subfoveal choroidal thickness in central serous chorioretinopathy following spontaneous resolution and low-fluence photodynamic therapy

Comparison of subthreshold micropulse laser (577 nm) treatment and half-dose photodynamic therapy in patients with chronic central serous chorioretinopathy

A 50% vs 30% Dose of Verteporfin (Photodynamic Therapy) for Acute Central Serous Chorioretinopathy

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