Journal of the Egyptian Ophthalmological Society (Jan 2015)
Comparison between the functional and anatomical outcomes of full-dose, half-dose photodynamic therapy and intravitreal bevacizumab in chronic central serous chorioretinopathy
Abstract
Purpose The aim of the present study was to compare the efficacy of full-dose, half-dose photodynamic therapy (PDT) and intravitreal bevacizumab (IVB) injection in treatment of chronic central serous chorioretinopathy (CCSC). Design The current study was retrospective, observational, and comparative in nature. Materials and methods We retrospectively reviewed the medical records of 80 eyes with CCSC in the form of four groups of 20 eyes each: group 1, in which the eyes were treated with full-dose verteporfin PDT (6 mg/m 2 ); group 2, in which the eyes were treated with half-dose verteporfin PDT (3 mg/m 2 ); group 3, in which the eyes were treated with IVB injection 1.25 mg/0.05 ml; and group 4, in which the eyes were only observed without treatment and therefore served as the control group. The primary outcome was the proportion of eyes with complete resolution of subretinal fluid on the last follow-up. The secondary outcomes included the mean changes in the best-corrected visual acuity, central retinal thickness in optical coherence tomography, and absent leakage in fundus fluorescein angiography from baseline to 12 months. Results Overall, complete resolution of subretinal fluid at 12-month follow-up was achieved in 18 eyes (90.0%) in group 1, 17 eyes (85%) in group 2, nine eyes (45%) in group 3, and five eyes (25%) in group 4. The improvement in best-corrected visual acuity was statistically significant in groups 1 and 2 (P < 0.05), although the difference between them was not statistically significant (P = 0.58). The mean change in central retinal thickness over 12 months from baseline was 122, 118, 70, and 40 μm in group 1, 2, 3 and, 4, respectively. Retreatment were given if persistence or recurrence was noted, with an average of 1.5, 1.4, and 6 retreatment in groups 1, 2, and 3, respectively. Conclusion Half-dose PDT is an alternative treatment in patients with CCSC. It has more efficacy than IVB and observation, and is safer than full-dose PDT. Larger multicenter prospective randomized control study of longer duration of follow-up is recommended.
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