Effectiveness of Reduced-fluence Photodynamic Therapy for Chronic Central Serous Chorioretinopathy

Nao Aisu, MD; Masahiro Miyake, MD, PhD; Yoshikatsu Hosoda, MD, PhD; Yuki Mori, MD; Ayako Takahashi, MD, PhD; Yuki Muraoka, MD, PhD; Naoko Ueda-Arakawa, MD, PhD; Manabu Miyata, MD, PhD; Akio Oishi, MD, PhD; Hiroshi Tamura, MD, PhD; Sotaro Ooto, MD, PhD; Kenji Yamashiro, MD, PhD; Akitaka Tsujikawa, MD, PhD

Ophthalmology Science (Jun 2022)

Effectiveness of Reduced-fluence Photodynamic Therapy for Chronic Central Serous Chorioretinopathy

Nao Aisu, MD,
Masahiro Miyake, MD, PhD,
Yoshikatsu Hosoda, MD, PhD,
Yuki Mori, MD,
Ayako Takahashi, MD, PhD,
Yuki Muraoka, MD, PhD,
Naoko Ueda-Arakawa, MD, PhD,
Manabu Miyata, MD, PhD,
Akio Oishi, MD, PhD,
Hiroshi Tamura, MD, PhD,
Sotaro Ooto, MD, PhD,
Kenji Yamashiro, MD, PhD,
Akitaka Tsujikawa, MD, PhD

Affiliations

Nao Aisu, MD: Department of Ophthalmology and Visual Sciences, Kyoto University Graduate School of Medicine, Kyoto, Japan
Masahiro Miyake, MD, PhD: Department of Ophthalmology and Visual Sciences, Kyoto University Graduate School of Medicine, Kyoto, Japan; Center for Genomic Medicine, Kyoto University Graduate School of Medicine, Kyoto, Japan; Correspondence: Masahiro Miyake, MD, PhD, Department of Ophthalmology and Visual Sciences, Kyoto University Graduate School of Medicine, 54 Shogoin, Kawahara, Sakyo, Kyoto 606-8507, Japan.
Yoshikatsu Hosoda, MD, PhD: Department of Ophthalmology, Osaka Red Cross Hospital, Osaka, Japan
Yuki Mori, MD: Department of Ophthalmology and Visual Sciences, Kyoto University Graduate School of Medicine, Kyoto, Japan
Ayako Takahashi, MD, PhD: Department of Ophthalmology and Visual Sciences, Kyoto University Graduate School of Medicine, Kyoto, Japan
Yuki Muraoka, MD, PhD: Department of Ophthalmology and Visual Sciences, Kyoto University Graduate School of Medicine, Kyoto, Japan
Naoko Ueda-Arakawa, MD, PhD: Department of Ophthalmology and Visual Sciences, Kyoto University Graduate School of Medicine, Kyoto, Japan
Manabu Miyata, MD, PhD: Department of Ophthalmology and Visual Sciences, Kyoto University Graduate School of Medicine, Kyoto, Japan
Akio Oishi, MD, PhD: Department of Ophthalmology and Visual Sciences, Kyoto University Graduate School of Medicine, Kyoto, Japan; Department of Ophthalmology and Visual Sciences, Graduate School of Biomedical Sciences, Nagasaki University, Nagasaki, Japan
Hiroshi Tamura, MD, PhD: Department of Ophthalmology and Visual Sciences, Kyoto University Graduate School of Medicine, Kyoto, Japan
Sotaro Ooto, MD, PhD: Department of Ophthalmology and Visual Sciences, Kyoto University Graduate School of Medicine, Kyoto, Japan
Kenji Yamashiro, MD, PhD: Department of Ophthalmology and Visual Sciences, Kyoto University Graduate School of Medicine, Kyoto, Japan; Department of Ophthalmology, Otsu Red Cross Hospital, Shiga, Japan
Akitaka Tsujikawa, MD, PhD: Department of Ophthalmology and Visual Sciences, Kyoto University Graduate School of Medicine, Kyoto, Japan

Journal volume & issue: Vol. 2, no. 2
p. 100152

Abstract

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Purpose: To investigate the 2-year effectiveness of reduced-fluence photodynamic therapy (rf-PDT) for chronic central serous chorioretinopathy (cCSC). Design: Retrospective cohort study. Participants: A total of 223 consecutive patients with newly diagnosed cCSC with active serous retinal detachment (SRD) were included from May 2007 to June 2017 and followed up for at least 2 years. Patients who underwent ocular treatment other than cataract surgery before the beginning of recruitment and those who had macular neovascularization at baseline were excluded. Methods: All patients underwent a comprehensive ophthalmic evaluation, including measurements of best-corrected visual acuity (BCVA), slit-lamp examination, dilated fundus examination, color fundus photography, fundus autofluorescence, fluorescein angiography, indocyanine green angiography, and spectral-domain OCT. An inverse probability of treatment weighting (IPTW) methodology was applied to balance 18 baseline characteristics between patients who received rf-PDT (rf-PDT group) and those who did not receive treatment (controls). Inverse probability of treatment weighting survival analysis and regression were performed. Main Outcome Measures: The proportion of patients whose BCVA at 24 months was the same or improved compared with the baseline visual acuity (VA) (VA maintenance rate). Results: A total of 155 eyes (rf-PDT group: 74; controls: 81) were analyzed. The patients’ backgrounds were well balanced after IPTW with standardized differences of < 0.10. An IPTW regression analysis revealed that the VA maintenance rate was significantly higher in the rf-PDT group than in the controls (93.6% vs. 70.9%, P < 0.001, 12 months; 85.7% vs. 69.8%, P = 0.019, 24 months). The rf-PDT group tended to show better VA improvement, but was not statistically significant (–0.06 vs. –0.008, P = 0.07, 12 months; –0.06 vs. –0.03, P = 0.32, 24 months). An IPTW Cox regression showed a significantly higher rate of complete SRD remission in the rf-PDT group (hazard ratio, 5.05; 95% confidence interval, 3.24–7.89; P < 0.001). Conclusions: The study suggests the beneficial effect of rf-PDT for cCSC for both VA maintenance and higher proportion of complete SRD remission in the clinical setting.

Published in Ophthalmology Science

ISSN: 2666-9145 (Online)
Publisher: Elsevier
Country of publisher: United States
LCC subjects: Medicine: Ophthalmology
Website: https://www.journals.elsevier.com/ophthalmology-science/

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