Half-Fluence Photodynamic Therapy in Chronic Central Serous Chorioretinopathy

Abstract

ICGA-guided half-fluence PDT with verteporfin is effective in treating chronic symptomatic central serous chorioretinopathy with choroidal hyperpermeability in ICGA, resulting in both visual improvement and reduction of central foveal thickness.

Intravitreal anti-vascular endothelial growth factor combined with half-fluence photodynamic therapy for choroidal neovascularization in chronic central serous chorioretinopathy

“…[1][2][3][15][16][17][18][19][20][21] In a retrospective study, Mudvari et al 29 found that none of the 340 consecutive CSCR patients developed CNV during an approximate 4-year follow-up period (mean of 49 months). However, Spaide et al 30 reported that older patients with CSCR had a lower VA, and were more likely to have diffuse retinal pigment epitheliopathy and secondary CNV than their younger counterparts.…”

“…In this study, experience due to previous studies conducted at our tertiary center on acute and chronic CSCR enabled us to follow a PDT regimen, using half-dose fluence rate (25 J/cm 2 ), while not changing the dose of verteporfin (6 mg/m 2 ). [16][17][18] Selecting an appropriate fluence rate helps avoiding collateral damage as atrophy of the RPE, choroidal ischemia, and development of secondary CNV due to less choriocapillaris damage. [18][19][20] Said avoidance of negative treatment effect of RPE's metabolic activity was shown in a study of Hagen et al, 36 where the focus was set on RPE alterations in eyes with acute CSCR treated with half-fluence PDT observed via shortwavelength fundus autofluorescence.…”

“…This has led to promising results in a previous study conducted in our tertiary care center. [16][17][18]22,23 Intravitreal anti-VEGF Patients received 0.5/1.25 mg of IVR/IVB under sterile conditions. Fourteen (82.3%) eyes received IVR and three (17.7%) eyes received IVB on a pro re nata regimen.…”

“…14 Promising results of previous studies on acute and chronic CSCR conducted at our tertiary center allow us to follow a PDT regimen, using half-dose fluence rate (25 J/cm 2 ), while not changing the dose of verteporfin (6 mg/m 2 ). [16][17][18] Selecting an appropriate fluence rate avoids collateral damage such as atrophy of the RPE, choroidal ischemia, and development of secondary CNV due to less choriocapillaris damage. [19][20][21] This retrospective study targets on a treatment regimen for CNV in chronic CSCR that has not been described in literature before: a combination of IVR/IVB and ICGAguided PDT with half-fluence rate.…”

Photodynamic therapy: current role in the treatment of chorioretinal conditions

“…13,[48][49][50][51][52] Reduced fluence vPDT therapy uses a vPDT laser fluence of 25 J/cm 2 (300 mW/cm 2 for 83 s). 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.…”