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Low-fluence PDT may be safer than standard-fluence PDT for central serous chorioretinopathy
Am J Ophthalmol. 2009;149(2):307-315.
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Low-fluence photodynamic therapy achieved similar visual and anatomic outcomes as standard-fluence photodynamic therapy but with fewer adverse outcomes in a study comparing the two modalities in treating chronic central serous chorioretinopathy.
In the study of 42 eyes of 42 patients, 19 eyes received standard-fluence PDT (50 J/cm2) and 23 received low-fluence PDT (25 J/cm2), both aided by indocyanine green angiography. Best corrected visual acuity improved significantly at all time points in the study in both groups.
In the standard-fluence group, BCVA improved from 0.43 logMAR at baseline to 0.24 logMAR at 12 months, and in the low-fluence group, BCVA changed from 0.46 logMAR at baseline to 0.16 logMAR at 12 months. There was no difference between the two groups, according to the study.
At 12 months, complete subretinal reabsorption was seen in 79% of eyes in the standard-fluence group and in 91% in the low-fluence group, but the difference was not statistically significant. Central foveal thickness also improved in both groups with no intergroup difference.
However, grading of choroidal perfusion favored the low-fluence group. At 3 months, grade 2 or higher perfusion was evident in 12 eyes (67%) in the standard-fluence group and in two eyes (9%) in the low-fluence group. At 12 months, grade 2 or higher perfusion was still evident in eight eyes (44%) in the standard-fluence group but in no eyes in the low-fluence group.
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