J Korean Ophthalmol Soc.  2013 Jul;54(7):1046-1053. 10.3341/jkos.2013.54.7.1046.

Comparison of Very Low Fluence and Low Fluence Photodynamic Therapy in Chronic Central Serous Chorioretinopathy

• Oh HJ
• Chang W
• Sagong M

• KMID: 2217414
• DOI: http://doi.org/10.3341/jkos.2013.54.7.1046

Abstract

PURPOSE
To investigate the safe, effective light dose for photodynamic therapy (PDT) in the treatment of chronic central serous chorioretinopathy (CSC).
METHODS
Thirty-eight eyes of 37 patients with chronic CSC were recruited for this study. From November 2009 to July 2010 and from April 2011 to February 2012, PDT was performed using 50% and 25% of the full light dose in 27 eyes of 27 patients (group I) and 11 eyes of 10 patients (group II), respectively. The minimum follow-up period was 6 months. Mean change in best corrected visual acuity (BCVA) and central retinal thickness, hyperpermeability change from abnormal choriocapillaris, success rate, recurrence rate, and complications were analyzed.
RESULTS
Group I showed that BCVA (log MAR) improved significantly from 0.33 +/- 0.17 to 0.14 +/- 0.15 at 6 months (p < 0.001). However, there was no significant improvement of BCVA (p = 0.050) in group II. One eye out of 27 eyes (3.7%) in group I and 5 eyes out of 11 eyes (45.5%) in group II showed recurrence at the 6-month follow-up (p = 0.016). After initial PDT, hyperpermeability from abnormal choriocapillaris reduced or disappeared at 95.5% in group I and 54.5% in group II at month 3 (p = 0.016). No patient in either group experienced severe adverse events.
CONCLUSIONS
PDT performed with 50% of the full light dose appears to be a more useful method in the treatment of chronic CSC, with less frequent recurrence, than PDT using 25% of the full light dose.

Keyword

Central serous chorioretinopathy; Photodynamic therapy; Very low fluence

MeSH Terms

Central Serous Chorioretinopathy
Eye
Follow-Up Studies
Humans
Light
Photochemotherapy
Recurrence
Retinaldehyde
Triazenes
Visual Acuity
Retinaldehyde
Triazenes

Figure

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  Figure 1. Graph showing the serial changes in mean BCVA (best-corrected visual acuity) of patients in the 50% PDT group and in the 25% PDT group. While 50% PDT group showed significant visual improvement at month 3 and month 6 after treatment, 25% PDT group showed no significant visual improvement. And there was no significant difference in mean change of BCVA at every follow-up period between two groups.

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  Figure 2. Graph showing the serial changes in mean CMT (central macular thickness) in the 50% PDT group and in the 25% PDT group. 25% PDT group showed no significant decrease in CMT at month 3 after treatment but had significance at month 6. Meanwhile, 50% PDT group showed significance at every follow-up period. There was no significant difference in mean change of CMT at every follow-up period between two groups.

Reference

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