Half-dose photodynamic therapy versus 577 nm subthreshold pulse laser therapy in treatment-naive patients with central serous chorioretinopathy

Vasilena Sitnilska; Petra Schiller; Tim U Krohne; Lebriz Altay

doi:10.1186/s12886-023-03274-9

Half-dose photodynamic therapy versus 577 nm subthreshold pulse laser therapy in treatment-naive patients with central serous chorioretinopathy

BMC Ophthalmol. 2024 Jan 4;24(1):8. doi: 10.1186/s12886-023-03274-9.

Authors

Vasilena Sitnilska¹, Petra Schiller², Tim U Krohne³, Lebriz Altay³

Affiliations

¹ Department of Ophthalmology, Faculty of Medicine, University Hospital Cologne, University of Cologne, Cologne, Germany. vasilena.sitnilska@uk-koeln.de.
² Institute of Medical Statistics and Computational Biology (IMSB), Faculty of Medicine, University of Cologne, Cologne, Germany.
³ Department of Ophthalmology, Faculty of Medicine, University Hospital Cologne, University of Cologne, Cologne, Germany.

Abstract

Background: To compare real-life anatomical and functional outcomes of half-dose photodynamic therapy (HD-PDT) and 577 nm subthreshold pulse laser therapy (SPL) in treatment-naïve patients with central serous chorioretinopathy (CSC).

Methods: We retrospectively reviewed consecutive treatment-naïve CSC patients with non-resolving subretinal fluid (SRF) for more than 2 months who received either HD-PDT or SPL treatment. One repetition of the same treatment was allowed in patients with persistent SRF after first treatment. Functional and anatomical outcomes were assessed after first treatment and at final visit.

Results: We included 95 patients (HD-PDT group, n = 49; SPL group, n = 46). Complete resolution of SRF after a single treatment was observed in 42.9% of HD-PDT-treated patients (n = 21; median time to resolution 7.1 weeks) and in 41.3% of SPL-treated patients (n = 19; median time to resolution 7.0 weeks). In the HD-PDT-group, 44.9% of patients (n = 22) and in the SPL-group, 43.5% (n = 20) of patients, received a second treatment due to persistent SRF, while 12.2% (n = 6) and 15.2% (n = 7), respectively, opted against a second treatment despite persistent SRF. After the final treatment, complete SRF resolution was observed in 61.2% of all HD-PDT-treated patients (n = 30; median time to resolution 8.8 weeks) and 60.9% of all SPL-treated patients (n = 28; median time to resolution 13.7 weeks, p = 0.876). In the final visit, both groups showed significant improvement of BCVA in comparison to baseline (p < 0.001 for all). The change in BCVA from baseline to final visit was similar for the two groups (HD-PDT, median BCVA change 0.10 logMAR (IQR: 0.0-0.2); in SPL group, median BCVA change 0.10 logMAR (IQR: 0.0-0.2), P = 0.344). The CSC subclassification (simple versus complex) had no influence on the anatomical or functional outcome.

Conclusions: High-density 577 nm SPL resulted in as good anatomical and functional treatment as HD-PDT and may thus represent a treatment alternative to HD-PDT in CSC.

Keywords: Central serous chorioretinopathy; Half-dose photodynamic therapy; Prognostic factors; Subliminal laser.

MeSH terms

Central Serous Chorioretinopathy* / diagnosis
Central Serous Chorioretinopathy* / drug therapy
Chronic Disease
Fluorescein Angiography
Follow-Up Studies
Humans
Laser Therapy* / methods
Photochemotherapy* / methods
Photosensitizing Agents / therapeutic use
Retrospective Studies
Tomography, Optical Coherence
Verteporfin / therapeutic use

Substances

Photosensitizing Agents
Verteporfin