Comparison of efficacy between low-fluence and half-dose verteporfin photodynamic therapy for chronic central serous chorioretinopathy

Abstract

Zeynep Alkin,1 Irfan Perente,1 Abdullah Ozkaya,1 Dilek Alp,1 Alper Agca,1 Ebru Demet Aygit,1 Selcuk Korkmaz,2 Ahmet Taylan Yazici,1 Ahmet Demirok1 1Beyoglu Eye Training and Research Hospital, Istanbul, Turkey; 2Hacettepe University Faculty of Science, Department of Statistics, Ankara, Turkey Purpose: To compare the efficacy of low-fluence photodynamic therapy (PDT) and PDT with half-dose verteporfin in chronic central serous chorioretinopathy (CSC). Patients and methods: The medical records of 64 eyes from 60 patients with chronic CSC were retrospectively reviewed; 36 eyes received low-fluence PDT (25 J/cm2) and 28 eyes received half-dose verteporfin PDT (3 mg/m2). The primary outcome measure was the proportion of eyes with complete resolution of subretinal fluid. Secondary outcome measures were the changes in best corrected visual acuity (BCVA) and central foveal thickness, and the proportion of eyes that showed an increase of ≥5 letters in BCVA at the last visit. Results: The mean follow-up period was12.5±4.3 months and 13.1±4 months in the low-fluence group and half-dose group, respectively (P=0.568). Thirty-three eyes (91.6%) in the low-fluence group and 26 eyes (92.8%) in the half-dose verteporfin group showed complete resolution of subretinal fluid (P=0.703). BCVA increased by a mean of 7.4 letters and 4.8 letters in the low-fluence group and half-dose group, respectively (P=0.336). Seventeen eyes (52.8%) in the low-fluence group and 14 eyes (50%) in the half-dose group experienced a gain of ≥5 letters in BCVA (P=0.825). In the low-fluence and half-dose verteporfin group, the mean baseline central foveal thickness was 351±90 µm and 341±96 µm, and significantly decreased to 188±61 µm and 181±47 µm, respectively (P<0.01). Conclusion: Both treatments resulted in complete subretinal fluid resolution in most of the eyes, with significantly better visual acuity outcomes compared to baseline at the last visit. Keywords: low-fluence, half-dose verteporfin, photodynamic therapy, central serous chorioretinopathy