Half-dose photodynamic therapy targeting the leakage point on the fluorescein angiography in acute central serous chorioretinopathy: a pilot study

Am J Ophthalmol. 2014 Feb;157(2):366-373.e1. doi: 10.1016/j.ajo.2013.10.013. Epub 2013 Nov 1.

Abstract

Purpose: To evaluate the efficacy of half-dose photodynamic therapy (PDT) targeting only the focal leakage point on fluorescein angiography for acute central serous chorioretinopathy.

Design: Nonrandomized, retrospective, comparative, interventional case series.

Methods: Ten consecutive eyes with acute central serous chorioretinopathy underwent PDT, and later, 11 eyes were observed without treatment. Main outcome measures included achievement of complete resolution of subretinal fluid, change in best-corrected visual acuity, and central retinal sensitivity.

Results: Complete resolution of subretinal fluid was achieved in 80.0% and 18.2% of eyes in the PDT group and the observation group at 1 month (P = .009), 100% and 27.3% at 3 months (P = .001), and 90% and 63.6% at 12 months (P = .311), respectively. At 12 months, 3 eyes (27%) in the observation group had a persistent lesion, whereas no such lesions were observed in the eyes in the PDT group. One eye in each group showed recurrence during the 12-month follow-up period. Visual acuity improved significantly in both groups at each time point, and the differences between groups were not significant. The mean central retinal sensitivity at 3 months was significantly higher in the PDT group compared with the observation group.

Conclusions: Fluorescein angiography-guided half-dose PDT seems to facilitate faster resolution of subretinal fluid in acute central serous chorioretinopathy without, however, convincing long-term anatomic and functional benefits. This protocol may enhance the safety of PDT further.

MeSH terms

  • Acute Disease
  • Adult
  • Capillary Permeability / drug effects
  • Central Serous Chorioretinopathy / diagnosis
  • Central Serous Chorioretinopathy / drug therapy*
  • Female
  • Fluorescein Angiography
  • Humans
  • Lasers
  • Male
  • Middle Aged
  • Photochemotherapy*
  • Photosensitizing Agents / administration & dosage*
  • Pilot Projects
  • Porphyrins / administration & dosage*
  • Retrospective Studies
  • Subretinal Fluid / drug effects
  • Treatment Outcome
  • Verteporfin
  • Visual Acuity

Substances

  • Photosensitizing Agents
  • Porphyrins
  • Verteporfin