Comparison of half-fluence versus quarter-fluence photodynamic therapy in chronic central serous chorioretinopathy

Session Details

Session Title: Free Paper Session 23: Vascular Diseases & Diabetic Retinopathy VI

Session Date/Time: Sunday 10/09/2017 | 08:00-09:30

Paper Time: 08:54

Venue: Room 120

First Author: : H.Wang UK

Co Author(s): :    H. Wang   T. Aslam   S. Mahmood   Y. D'Souza   R. Chhabra   K. Balaskas              

Abstract Details

Purpose:

To compare the efficacy of half-fluence photodynamic therapy (PDT) performed using full-time as opposed to half-time duration in patients diagnosed with chronic central serous chorioretinopathy (CSR).

Setting:

Macular Treatment Outpatient Centre at Manchester Royal Eye Hospital, United Kingdom

Methods:

A retrospective review was performed on 63 eyes of 56 consecutive chronic CSR patients, treated by indocyanine green angiography guided vertepofrin (6 mg/m2) half-fluence (300 mW/cm2) PDT using either full-time (83 seconds) or half-time (42 seconds) duration between January 2014 and January 2017. Data on patients’ best-correct visual acuity (BCVA, recorded as letters according to Early Treatment Diabetic Retinopathy Study chart) and central macular thickness (CMT) at baseline pre-PDT and 1 month, 3 months and 12 months post-PDT were collected. Resolution of subretinal fluid (SRF) and recurrence of CSR were also assessed.

Results:

7 eyes (7 patients) were lost in follow-ups hence excluded from data analysis. BCVA was significantly improved from 68±9 letters at baseline pre-PDT to 1 month (71±10 letters), 3 months (71±11 letters) and 12 months (73±9 letters) post-PDT in the full-time group (n=26) (all P<0.005, Wilcoxon signed-rank test); whereas, BCVA post-PDT did not show significant improvement in the half-time group (n=30) (62±16 letters at baseline to 65±17 letters at 1 month, 59±19 letters at 3 months, and 61±16 letters at 12 months, all P>0.05). BCVA at 12 months post-PDT differed significantly between the two groups (P<0.05) although BCVA at baseline pre-PDT, 1 month and 3 months post-PDT did not show significant differences (all P>0.05, Mann-Whitney U test). CMT was significantly improved at all post-PDT follow-ups in both groups (all P<0.001, paired t-test) compared with the baseline and there was no significant difference at baseline or any follow-ups between the two groups (all P>0.05, student’s t-test). 77% and 74% of eyes in the full-time and half-time groups respectively had complete absorption of SRF by 12 months post-PDT (P>0.05, Chi-square test). 27% and 17% of eyes in the full-time and half-time groups respectively had recurrence of CSR by 12 months post-PDT (P>0.05).

Conclusions:

Although both full-time and half-time PDTs were similarly effective in improving anatomical outcomes, it seemed full-time PDT was functionally better in improving patients’ visual acuity than half-time PDT.

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