Long-Term Effect of Half-Fluence Photodynamic Therapy on Fundus Autofluorescence in Acute Central Serous Chorioretinopathy

Abstract

Purpose. To evaluate normalized short-wavelength fundus autofluorescence (SW-FAF) imaging changes over time as a predictive parameter for the retinal pigment epithelium (RPE) function in eyes compromised by acute central serous chorioretinopathy (CSCR) after indocyanine green angiography-guided verteporfin (Visudyne®, Novartis Pharma, Basel, Switzerland) photodynamic therapy (PDT) with a half-fluence rate (25 J/cm2). Methods. Quantitative data of SW-FAF grey values (SW-FAF GV) from a 350 μm (SW-350) and 1200 μm (SW-1200) diameter circle centered on the fovea and normalized with the level of SW-FAF GV in a 30° image of 20 eyes in 11 patients initially treated for unilateral acute symptomatic CSCR were collected and retrospectively analyzed after 7 years. A 2-sided t-test was calculated to explore the differences of SW-350 and SW-1200 between one month and the long-term follow-up. Results. Mean differences (95% CI) in SW-FAF GV between 1 month and 7 years after half-fluence PDT were 0.07 ± 0.11 for SW-350 ([95% CI: −0.002; 0.14], p=0.06) and 0.11 ± 0.15 for SW-1200 ([95% CI: 0.01; 0.21], p=0.03). Mean differences in SW-FAF GV of the contralateral untreated eye were 0.06 ± 0.14 for SW-350 ([95% CI: −0.04; 0.17], p=0.22) and 0.05 ± 0.13 for SW-1200 ([95% CI: −0.04; 0.15], p=0.22). Conclusion. After 7 years, normalized SW-FAF GV were significantly lower in eyes with resolved acute CSCR treated with reduced-fluence PDT compared to the follow-up after 1 month without correlation to explicit pattern changes or structural damages. Half-fluence PDT remains a safe and considerable treatment option in acute CSCR.

Vitreoretinal Society of India practice pattern survey 2020: Medical retina

“…Stattin et al have shown that reduced fluence PDT is an is a safe and considerable treatment option in acute CSCR. [ 9 ] Micropulse laser causes negligible thermal damage to the retina, thereby making it suitable for application in subfoveal leak. [ 10 ] For chronic CSCR, PDT has been shown to be superior to subthreshold laser in the resolution of subretinal fluid and functional outcomes.…”

Photo-activated disinfection with light-emitting diode reduces some key periodontal pathogens in chronic periodontitis

“…12 With promising results using PDT was also reported in ophthalmology. 14,15 Diabetic foot ulcers are one of the main complications in diabetic patients with high morbidity and mortality. PDT was demonstrated to reduce the microbial loads in infected diabetic ulcers without bacterial resistance.…”