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Half-dose or half-time PDT improves visual acuity, reduces subretinal fluid
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Half-dose and half-time fluorescein angiography-guided photodynamic therapy yielded similar visual and anatomic results in the treatment of central serous chorioretinopathy, a study found.
The retrospective case series included 61 eyes with acute or chronic central serous chorioretinopathy involving the fovea. Half-dose PDT was performed in 35 eyes, and half-time PDT was performed in 26 eyes.
The half-dose regimen comprised irradiance of 600 mW/cm2, laser time of 83 seconds and verteporfin 3 mg/m2. The half-time regimen comprised irradiance of 600 mW/cm2, laser time of 42 seconds and verteporfin 6 mg/m2.
Mean follow-up after PDT was 14.8 months.
Both groups had significant gains in best corrected visual acuity compared with baseline at 1, 3, 6 and 12 months. BCVA improved more in the half-dose PDT group than in the half-time PDT group at 1 month and 3 months but not at 6 months and 12 months.
No eyes in the half-time PDT group and one eye in the half-dose PDT group had a loss of BCVA.
Subretinal fluid resolved within 1 month in 60% of patients in the half-dose PDT group and 81% of patients in the half-time PDT group; the between-group difference was not statistically significant.
Fluid resolved completely in all patients in the half-time PDT group at 6 months. Fluid resolved completely in 32 of 35 patients in the half-dose PDT group at 12 months, with three patients lost to follow-up. Subretinal fluid resolved significantly faster in the half-time PDT group than in the half-dose PDT group (P = .024).
Central serous chorioretinopathy recurred in three eyes in the half-dose PDT group and two eyes in the half-time PDT group. Subretinal fluid resolved in all recurrent cases after re-treatment.
No systemic or treatment-related side effects were reported. – by Matt Hasson
Disclosure: The authors report no relevant financial disclosures.
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Liu HY, et al. Am J Ophthalmol. 2016;doi:10.1016/j.ajo.2016.04.001.
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