Photodynamic therapy for treatment of chronic or recurrent central serous chorioretinopathy

Abstract

To evaluate the effect of Spectral HRA + OCT-guided photodynamic therapy with half-dose verteporfin in the treatment of chronic or recurrent central serous chorioretinopathy. It was a retrospective case series. Twenty eyes of 18 patients with chronic or recurrent central serous chorioretinopathy were included. PDT was applied with half-dose verteporfin (3 mg/m(2)) on the site of active area shown on Spectral HRA + OCT (defined as focal or diffuse retinal pigment epithelial leakage, choroidal hyperpermeability, or pigment epithelial detachment located within the neurosensory detachment), and patients were observed to determine the anatomic and functional outcomes. Statistical analysis was performed using SAS (version 9.2). A P value of 0.05 was considered statistically significant. Comparisons of pre- and post-treatment best-corrected visual acuity (BCVA) and central foveal thickness (CFT) were performed using a paired t test. The relationship between BCVA and CFT post-treatment was analyzed by linear correlation analysis. Comparisons of the BCVA of eyes with and without the integrity of photoreceptor IS-OS and/or external limiting membrane at the last follow-up visit were performed using two sample t test. The median CSC duration was 4.5 months (ranged 1 month to 2 years). The median follow-up period after PDT was 8 months (ranged 6 to 20 months). The mean BCVA before PDT was 0.35 ± 0.16 (ranged 0.05 to 0.6), at 3 months after PDT was 0.72 ± 0.32 (ranged 0.1 to 1.5) and at the last follow-up visit was 0.78 ± 0.29 (ranged 0.3 to 1.5) (t = 6.444, 6.883, P < 0.05). Fifteen eyes (75.0%) had improved vision, and 5 eyes (25.0%) had stable vision. The mean CFT was reduced from (369.0 ± 120.9) µm before PDT to (193.3 ± 30.6) µm 1 month after PDT, (194.9 ± 28.3) µm 3 month after PDT and (190.6 ± 33.7) µm at the last follow-up visit (t = -6.836, -6.826, -7.316; P < 0.05). At the last follow-up visit BCVA was not correlated with CFT (r = 0.166, P > 0.05), but BCVA of the eyes with the integrity of photoreceptor IS-OS and/or external limiting membrane was better than that of without (t = -3.53, P < 0.05). Subretinal fluid disappeared in all eyes 1 month after PDT and there was no recurrence during the follow-up. Spectral HRA + OCT-guided photodynamic therapy with half-dose of verteporfin seems effective and safe for the treatment of chronic or recurrent central serous chorioretinopathy.