Low dose verteporfin (1.5mg/m2) in chronic idiopathic central serous chorioretinopathy

Abstract

Abstract Purpose In chronic idiopathic central serous chorioretinopathy (ICSC), recent studies indicate that photodynamic therapy (PDT) could be effective in subretinal fluid resorption with reduced dose of verteporfin (3mg/m2) and reduced fluence PDT. However safety and cost issues remain to be addressed. This prospective randomized controlled study has been designed to evaluate the efficacy of a further reduced dose of verteporfin for PDT in chronic ICSC. Methods Patients with chronic ICSC greater than 3 months of documented duration were included. Visual acuity had to be <20/40. The patients were randomly assigned to 2 treatment groups. They received either 3 mg/m2 or 1,5 mg/m2 verteporfin and reduced fluence PDT. All patients had visual acuity, ocular coherent tomography (OCT), fluorescein and indocyanine green (ICG) angiography on inclusion, follow up was based on ETDRS and OCT at 6 weeks, 3 and 6 months. Results Ten patients were included, randomized to each treatment group. Mean duration of symptoms prior to PDT was 6 months. After 6 month follow‐up, no significant difference between the 2 groups was observed: the reduction of mean foveal thickness was equivalent in both groups. In all treated eyes, visual acuity remained stable or improved. OCT showed a reduction in serous detachment in 2 eyes of 10 eyes, complete resolution was demonstrated in 8 of 10 eyes. None of the eyes required more than 1 treatment for recurrent serous detachment. Conclusion Our preliminary data suggest that PDT leads to resolution of serous detachments and visual improvement in patients with chronic ICSC even with a low dose of verteporfin. This will reduce the cost of PDT for each patient. Long term follow‐up should enable to address safety issues.